Hypercalcemia induced by 13-cis-retinoic acid in a patient with neuroblastoma

• Published in: Pharmacotherapy Vol. 22; no. 5; p. 645
• Main Authors: Belden, Tara L, Ragucci, Dominic P
• Format: Journal Article
• Language: English
• Published: United States 01.05.2002
• Subjects: Brain Neoplasms - complications; Child; Female; Humans; Hypercalcemia - blood; Hypercalcemia - chemically induced; Isotretinoin - adverse effects; Keratolytic Agents - adverse effects; Neoplasm Recurrence, Local - surgery; Neoplasm Recurrence, Local - therapy; Neuroblastoma - complications
• ISSN: 0277-0008
• DOI: 10.1592/phco.22.8.645.33207

Hypercalcemia is a potential dosage-related adverse effect of 13-cis-retinoic acid in patients with neuroblastoma. Severe hypercalcemia requiring dosage reduction has been reported in children receiving 13-cis-retinoic acid 200 mg/m2/day and in those with concurrent renal impairment receiving 160 mg/m2/day. A 12-year-old girl without renal dysfunction, diagnosed with neuroblastoma, developed severe hypercalcemia requiring several hospitalizations while receiving 13-cis-retinoic acid 160 mg/m2/day. Her hypercalcemia resolved with hydration, diuretic therapy, and temporary discontinuation of 13-cis-retinoic acid. Despite a 50% dosage reduction to 80 mg/m2/day, severe hypercalcemia recurred with the next treatment cycle. Further treatment with 13-cis-retinoic acid was made tolerable by shortening the duration of the remaining cycles. Serum calcium levels should be monitored in patients with neuroblastoma who receive 13-cis-retinoic acid.