Assessment of Incidence and Character of Neurologic/ Neuropsychiatric Complications in a Group of Patients with Malignant Melanoma Treated with Adjuvant High Dose Interferon


Authors: Prošvicová Jarmila 1;  Grim Jiří 2;  Kopecký Jindřich 2;  Priester Peter 2;  Priester Iva 2;  Trojanová Petronela 2;  Jílková Věra 2;  Paulík Adam 2;  Lukešová Šárka 1;  Stanislav. Filip 2
Authors‘ workplace: Oddělení klinické onkologie, Oblastní nemocnice Náchod a. s. 1;  Klinika onkologie a radioterapie FN Hradec Králové 2
Published in: Klin Onkol 2018; 31(5): 361-365
Category: Original Articles
doi: 10.14735/amko2018361

Overview

Background:

Authors describe the incidence and character of neurologic and neuropsychiatric complications – particularly depression and parkinsonism – during adjuvant treatment of malignant melanoma (MM) with high dose interferon (HDI). Among the most frequently observed side effects are fatigue, hematotoxicity, and hepatotoxicity. Most research has been directed at depression and parkinsonism because of the lack of literature concerning these complications. Interferon induced parkinsonism has only been described rarely and only in case reports.

Patients and methods:

Twenty-nine patients with MM, treated from January 2010 to January 2014 with adjuvant high dose interferon alfa-2b intravenous (HDI 20MIU/sqm for 5 days per week during the first 4 weeks, and then maintenance subcutaneous 10MIU/sqm up to a total time of 1 year) were retrospectively evaluated and the incidence and character of neurologic and neuropsychiatric complications were determined.

Results:

Significant neurologic and neuropsychiatric complications were observed in 3 of the 29 patients. Dose modifications were required in 2 cases. One case developed parkinsonism and treatment had to be stopped after 10 applications of intravenous interferon.

Conclusion:

High dose interferon can cause depression and parkinsonism. Prophylaxis with antidepressant medication can keep the incidence of depression as low as 10% or lower. Development of parkinsonism during HDI is rare. According to available reports, this is the first description of parkinsonism development related to HDI in MM.

Key words

malignant melanoma – high dose interferon – neurologic and neuropsychiatric complication – drug-induced depression – drug-induced  parkinsonism

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.

Submitted: 7. 4. 2018

Accepted: 16. 8. 2018


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