Tamoxifen Mitomycin

An unusual case of rapidly fatal renal failure reported in 1993 could reflect an interaction between tamoxifen and one or more cytostatic agents, with mitomycin C a prime suspect in a series of breast cancer patients some 10% of those treated both with tamoxifen and a cytostatic agent developed abnormal renal function, progressing towards various stages of hemolytic-uremic syndrome (118). 

Montes A, Powles TJ, O Brien ME, Ashley SE, Luckit J, Treleaven J. A toxic interaction between mitomycin C and tamoxifen causing the haemolytic uraemic syndrome. Eur J Cancer 1993 29A(13) 1854-7. 

Melanoma Dacarbazine, cisplatin, temozolomide Lomustine, hydroxyurea, mitomycin, dactinomycin, interferon, tamoxifen... 

MITOMYCIN HORMONES AND HORMONE ANTAGONISTS -TAMOXIFEN t incidence of anaemia and thrombocytopenia and risk of haemolytic-uraemic syndrome Mitomycin causes subdinical endothelial damage in addition to the thrombotic effect on platelets caused by tamoxifen, which leads to haemolytic-uraemic syndrome Monitor renal function at least twice weekly during concurrent therapy and watch clinically for bleeding episodes, e.g. nose bleeds, bleeding from the gums, skin bruising... 

Actinomycin D, bisantrene, chlorambncil, cisplatin, cytarabine, dannornbicin, docetaxel, doxorubicin, epirn-bicin, etoposide, flnoro uracil, hydroxyurea, mitomycin C, mitoxantrone, paclitaxel, tamoxifen, topotecan, taxol, vinblastine, vincristine. 

Hemolytic anemia, thrombocytopenia and renal dysfunction, leading to potentially fatal hemolytic uremic syndrome, can occur in patients given tamoxifen with or shortly after mitomycin C. Mitomycin C is contraindicated in patients with preexisting myelosupress-ion and anemia. 

Haemolytic anaemia, thrombocytopenia and renal impairment, leading to potentially fatal haemolytic uraemic syndrome, has occurred in a few patients given tamoxifen with, or shortly after, mitomycin. 

The authors of the first study suggested that this haemolytic uraemic syndrome was due to a combination of subclinical endothelial damage induced by mitomycin C, and a thrombotic effect on platelets caused by tamoxifen. They advise the avoidance of tamoxifen with or shortly after mitomycin C unless concurrent use ean be earefully monitored. Erythropoietin may be useful in managing the syndrome. This syndrome has also occurred rarely with mitomycin alone, or when combined with fluorouracil, see Mitomycin + Fluorouracil , above. 

EUis PA, Luckitt J, Treleaven J, SmithlE. Haemotytic uraemic syndrome in a patient with lui cancer further evidence for ataxic interaction between mitomycin-C and tamoxifen. Clin Oncol (R CollRadiol) (1996) 8,402-3. 

O Brien MER, Casey S, Treleaven J, Powles TJ. Use of eiythnpoietin in the management of die haemol34 ic uraemic syndrome induced by mitomycin C/tamoxifen. EurJ Cancer (1994)... 

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