Treatment of Vincristine-Induced Ileus With Metoclopramide: A Case Report Publisher Pubmed



Masoumi HT¹ ; Hadjibabaie M² ; Zarifyeganeh M³ ; Khajeh B¹ ; Ghavamzadeh A³ Show Affiliations
Source: Journal of Oncology Pharmacy Practice Published:2019

Abstract

Introduction: Acute lymphoblastic leukemia is an invasive malignancy which ought to be treated with several cytotoxic medications. Vincristine-based regimen is among the most commonly used regimens for the treatment of adult acute lymphoblastic leukemia. Peripheral neuropathy caused by vincristine provides a limitation in dose administration and can influence the treatment outcome and patient’s quality of life. Case presentation: Ileus and constipation occurred as a result of autonomic neuropathy in a 58-year-old man who underwent vincristine-based regimen for acute lymphoblastic leukemia treatment. Despite the administration of several laxative agents for constipation, the complication did not improve. So metoclopramide as a prokinetic agent was administered intravenously, and patient bowel movement and defecation started after 24 h. Conclusions: There is no approved protocol for vincristine-induced autonomic neuropathy treatment; thus, prokinetic agents such as metoclopramide can be considered as an option for ileus treatment after ruling out the possibility of bowel obstruction. Prophylactic stool softeners should be administrated in all patients undergoing chemotherapy with vincristine to prevent gastrointestinal motility disorders. © The Author(s) 2017.