melphalan and Alopecia

Permanent alopecia after BMT has been reported as a side-effect associated with GVHD or after busulphan conditioning therapy, primarily in adults. We have reviewed children undergoing BMT to document the frequency of incomplete hair regrowth and to evaluate factors associated with this problem. Hair regrowth was studied in 74 children who survived > 6 months following BMT undertaken for malignant and non-malignant diseases. Alopecia was categorised as severe (< 50% of pre-transplant status), moderate (50-75%) or mild (> 75% but less than normal). Overall, 18 (24.3%) of 74 patients had mild (n = 5), moderate (n = 4) or severe (n = 9) alopecia. Risk factors for alopecia were presence of chronic GVHD (67%; p < 0.001), older age (p < 0.001) and prior cranial irradiation (42%; p = 0.03). Alopecia occurred in children receiving either busulphan (31%) or total body irradiation (16%; p = 0.15) as conditioning therapy. The highest frequency was seen in patients conditioned with busulphan with or without melphalan and who received prior cranial irradiation and/or developed chronic GVHD (75%). These data indicate that alopecia after BMT in children is a significant problem and confirm, in children, the previously noted association between alopecia and chronic GVHD and busulphan. Further risk factors of older age and prior cranial irradiation are identified. Consideration needs to be given to the use of an alternative to busulphan in children who are of older age, have received prior cranial irradiation and/or are at increased risk of GVHD.

Topics: Adolescent; Adult; Age Factors; Alopecia; Bone Marrow Purging; Bone Marrow Transplantation; Busulfan; Child, Preschool; Chronic Disease; Cranial Irradiation; Female; Graft vs Host Disease; Hair; Humans; Infant; Leukemia; Male; Melphalan; Radiation Injuries; Risk Factors; Whole-Body Irradiation

We report on a patient with simultaneous manifestation of two different side-effects of a cytostatic therapy, which have to be ascribed to cytotoxic influences of different intensity. In this 37-year-old woman, "Mees-like" transverse white bands appeared on all the nails on the left hand after isolated cytostatic perfusion of the left arm. The nails on the right hand and the feet remained free of visible changes. However, the low doses of cytostatic drugs shunted into the systematic circulation induced diffuse toxic hair loss.

Topics: Adult; Alopecia; Antineoplastic Combined Chemotherapy Protocols; Chemotherapy, Cancer, Regional Perfusion; Cisplatin; Dose-Response Relationship, Drug; Drug Eruptions; Female; Forearm; Humans; Melanoma; Melphalan; Nail Diseases; Skin Neoplasms

After perioperative adjuvant chemotherapy of a sigma-adenocarcinoma with 400 mg peptichemio and 500 mg 5-fluorouracil a 61-year-old woman developed a severe intoxication: myelosuppression with pancytopenia, gastroenteritis and ulcerative proctitis, toxic hepato- and myocardiopathy, impaired renal function and alopecia. As a result of reduced resistance pneumonias, urinary tract infection, sepsis, cytomegaly infection and candidiasis of the oral mucosa occurred. The toxic effects are attributed mainly to the high dose of peptichemio.

Topics: Adenocarcinoma; Alopecia; Candidiasis, Oral; Diarrhea; Female; Fluorouracil; Hepatomegaly; Humans; Melphalan; Middle Aged; Peptichemio; Sigmoid Neoplasms

Topics: Alopecia; Amyloidosis; Blood Proteins; Drug Therapy, Combination; Eye Manifestations; Humans; Immunoglobulin D; Immunoglobulin Fragments; Keratosis; Male; Melphalan; Middle Aged; Mucinosis, Follicular; Mucous Membrane; Multiple Myeloma; Nails; Plasmacytoma; Prednisolone; Proteinuria; Scalp; Skin; Syndrome; Trichophyton

Topics: Adolescent; Adult; Alopecia; Bone Marrow Diseases; Bone Neoplasms; Cyclophosphamide; Female; Humans; Male; Melphalan; Sarcoma, Ewing; Vomiting