Table 3.

Toxicities observed during and after therapy with forodesine


Patient no.

Dose, mg/m2

Grades 1-2

Grades 3-4
1    
   Course 1   40   Hyperbilirubinemia, hypotension   Anasarca, dyspnea (increased pleural effusion), renal failure (irreversible), depressed level of consciousness, Gram-negative rod bacteremia, hypocalcemia* 
2    
   Course 1   40   Hypocalcemia,* headache,* nausea/vomiting,* constipation, orthostasis (autonomic), tremors   Hypoxemia (fluid overload),* neutropenia  
   Course 2   40   Orthostasis (autonomic), tremors   Neutropenia  
3    
   Course 1   40   Headache,* nausea/vomiting*  
4    
   Course 1   40   Headache,* constipation, elevation in ALT   Neutropenia, infection with neutropenia (catheter)  
5    
   Course 1   40   Stomatitis, peripheral neuropathy  Neutropenia  
   Course 2   40   Peripheral neuropathy, orthostasis, (autonomic)  Neutropenia  
   Course 3   60   Peripheral neuropathy, orthostasis, (autonomic)  Neutropenia  
   Course 4
 
90
 
Peripheral neuropathy, orthostasis (autonomic)
 
Neutropenia, fever without infection
 

Patient no.

Dose, mg/m2

Grades 1-2

Grades 3-4
1    
   Course 1   40   Hyperbilirubinemia, hypotension   Anasarca, dyspnea (increased pleural effusion), renal failure (irreversible), depressed level of consciousness, Gram-negative rod bacteremia, hypocalcemia* 
2    
   Course 1   40   Hypocalcemia,* headache,* nausea/vomiting,* constipation, orthostasis (autonomic), tremors   Hypoxemia (fluid overload),* neutropenia  
   Course 2   40   Orthostasis (autonomic), tremors   Neutropenia  
3    
   Course 1   40   Headache,* nausea/vomiting*  
4    
   Course 1   40   Headache,* constipation, elevation in ALT   Neutropenia, infection with neutropenia (catheter)  
5    
   Course 1   40   Stomatitis, peripheral neuropathy  Neutropenia  
   Course 2   40   Peripheral neuropathy, orthostasis, (autonomic)  Neutropenia  
   Course 3   60   Peripheral neuropathy, orthostasis, (autonomic)  Neutropenia  
   Course 4
 
90
 
Peripheral neuropathy, orthostasis (autonomic)
 
Neutropenia, fever without infection
 

All patients inevaluable for hematologic toxicity other than neutropenia owing to baseline cytopenias; patient no. 3. off-study day 10 of therapy for progression of disease and inevaluable for neutropenia owing to subsequent chemotherapy. Toxicities in patient no. 1 (renal failure, depressed level of consciousness) observed at day 21 and multifactorial in nature.

ALT indicates serum alanine aminotransferase.

*

During days of forodesine infusion

Present at baseline, progressed to grade 2 with course 2, then improved with subsequent courses, suspected related to prior vincristine

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