Leukopenia induced

Chemotherapeutic agents for cancer therapy are sometimes subjected to a limit of use because of the adverse effects. One of the critical adverse effects is leukopenia induced by a suppression of bone marrow hematopoiesis resulting in opportunistic infections. In this regard, an improvement of impaired hematopoiesis is required to obtain a satisfactory outcome in the cancer chemotherapy. 

Some interactions between lithium and other drugs are beneficial. In approximately 60% of depressed patients in whom conventional treatment has failed, the combination of lithium and antidepressant drugs proves successful where neither drug was effective alone (190, 193, 196, 197). Combinations of lithium and carbamazepine are also increasingly used in the successful treatment of refractory affective illness (198). This combination is generally safe, though the possibility of neurotoxicity should be considered. One additional potential benefit of the use of lithium in this way is the prevention of leukopenia induced by carbamazepine (199). Inosotol phospholipid metabolism is not affected by carbamazepine, suggesting an alternative locus of action from that of lithium (200). 

Yang, J. and Du, Y. Chemical modification, characterization and bioactivity of Chinese lacquer polysaccharides from lac tree Rhus vernicifera against leukopenia induced by cyclophosphamide. Carbohydr... 

There appear also to be toxic effects. In animals, nitrous oxide has been shown to inactivate methionine synthetase which prevents the conversion of deoxyuridine to thymidine and thus has the potential for inducing megaloblastic anemia, leukopenia, and teratogenicity (44—46). A variety of epidemiologic surveys suggest positive correlations between exposure to nitrous oxide and spontaneous abortion in dental assistants (47). 

Hogan, G.R. 1998. Selenate- and selenomethionine-induced leukopenia in ICR female mice. Jour. Toxicol. Environ. Health 53A 113-119. 

Methyldopa Autoimmune hemolytic anemia, leukopenia, drug-induced SLE, pemphigus... 

Ganciclovir (structure on p. 285) is given by infusion in the treatment of severe infections with cytomegaloviruses (also belonging to the herpes group) these do not induce thymi ne kinase, phosphorylation being initiated by a different viral enzyme. Ganciclovir is less well tolerated and, not infrequently, produces leukopenia and thrombo-penia. 

Dexrazoxane (Zinecard) [Chelating Agent] Uses Prevent anthracycline-induced (eg, doxorubicin) cardiomyopathy Action Chelates heavy metals binds intracellular iron prevents anthracycline-induced free radicals Dose 10 1 ratio dexrazoxane doxorubicin 30 min prior to each dose, 5 1 ratio w/ CrCl <40 mL/min Caution [C, ] Contra Component sensitivity Disp Inj SE -1-BM (esp leukopenia), fever, Infxn, stomatitis, alopecia, NA /D Interactions t Length of muscle relaxation Wf succinylcholine EMS Given concurrent w/a chemo agent for treating CA to prevent cardiotox monitor for Infxn and reduced cardiac Fxn use caution w/ succinylcholine, reduced doses may be needed OD May cause extreme BM suppression symptomatic and supportive... 

Autoimmune reactions associated with a-methyldopa treatment include thrombocytopenia and leukopenia. Since a few cases of an a-methyldopa-induced hepatitis have occurred, the drug is contraindicated in patients with active hepatic disease. FluUke symptoms also are known to occur. 

Although the MAOIs can have serious and potentially life-threatening adverse effects, it is the more common and less dramatic side effects that often lead to the discontinuation of MAOIs. These side effects include orthostatic hypotension, drowsiness, insomnia, edema, weight gain, sexual dysfunction, and precipitation of mania. Rare side effects include hepatitis and leukopenia. Parasthesias may develop secondary to a MAOI-induced pyridoxine deficiency, which responds to oral pyridoxine supplementation. Overall, phenelzine appears to be more sedating, whereas trancylpromine is more activating because of its stimulant-like properties. Meclobomide has more excitatory side effects, such as restlessness and insomnia. 

It is indicated in acute hypomania, mania, recurrent mania, depression - cyclic and recurring, unipolar depression, bipolar depression, schizoaffective psychosis, mental depression, cluster headache, chemotherapy induced leukopenia and agranulocytosis. 

G. Other applications Leukine has been effective in producing increases in normally functioning neutrophils, eosinophils, and monocytes in AIDS patients and patients with leukopenia. Leukine may prolong survival when used as adjuvant therapy in patients with stage III or IV malignant melanoma. Leukine has also been effective in abrogating chemotherapy-related neutropenia in cancer patients, with a reduction in the severity and duration of chemotherapy-induced myelosuppression. 

Skin reactions occur early in therapy but can subside with continued treatment. Jaundice, which can also occur early, is of the cholestatic type, similar to that attributed to chlorpromazine. Agranulocytosis is a rare complication, as are cases of leukocytosis, leukopenia, and eosinophilia. There are no data on the incidence of antidepressant-induced agranulocytosis, except to note that it is rare with all of the agents discussed in this chapter. 

The side effects of mycophenolate mofetil include diarrhea, abdominal pain, constipation, nausea/vomiting, acne, dyspnea, cough, peripheral edema, increased risk of infections, drug-induced fever, dizziness, headaches, leukopenia and anemia. 

Hong JC, Kahan BD. 2000. Sirolimus-induced thrombocytopenia and leukopenia in renal transplant recipients Risk factors, incidence, progression and management. Transplantation. 69 2085-2090. 

Galski H, Sullivan M, Willingham MC, et al. Expression of a human multidrug resistance cDNA (MDR1) in the bone marrow of transgenic mice resistance to daunomycin-induced leukopenia. Mol Cell Biol 1989 9(10) 4357 4363. 

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