Recognition and management of methemoglobinemia and hemolysis in a G6PD‐deficient patient on experimental anticancer drug Triapine

• Published in: American journal of hematology Vol. 81; no. 3; pp. 210 - 211
• Main Authors: Foltz, Lynda M., Dalal, Bakul I., Wadsworth, Louis D., Broady, Raewyn, Chi, Kim, Eisenhauer, Elizabeth, Kobayashi, Ken, Kollmannsburger, Christian
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01-03-2006; Wiley-Liss
• Subjects: Anemias. Hemoglobinopathies; Antineoplastic Agents - administration & dosage; Antineoplastic Agents - adverse effects; Biological and medical sciences; Carcinoma, Renal Cell - complications; Carcinoma, Renal Cell - drug therapy; Diseases of red blood cells; experimental anti‐cancer drug; G6PD deficiency; G6PD screening; Glucosephosphate Dehydrogenase Deficiency - complications; Hematologic and hematopoietic diseases; hemolysis; Hemolysis - drug effects; Humans; Medical sciences; Methemoglobinemia - chemically induced; Middle Aged; Pyridines - administration & dosage; Pyridines - adverse effects; severe methemoglobinemia; Thiosemicarbazones - administration & dosage; Thiosemicarbazones - adverse effects; Triapine; Antineoplastic agent; Human; Hemolysis; Drug; Hemoglobinopathy; Glucose-6-phosphate 1-dehydrogenase; Hematology; Enzyme; Triapine; Hemopathy; severe methemoglobinemia; Clinical management; Treatment; G6PD screening; Oxidoreductases; Methemoglobinemia; experimental anti-cancer drug; G6PD deficiency
• ISSN: 0361-8609; 1096-8652
• DOI: 10.1002/ajh.20547

We report occurrence of severe methemoglobinemia in a patient on novel experimental anti‐cancer drug, Triapine. Treatment with methylene blue led to massive hemolysis due to concomitant G6PD deficiency. We recommend that G6PD screening be done in high‐risk populations prior to commencement of Triapine therapy. Am. J. Hematol. 81:210–211, 2006. © 2006 Wiley‐Liss, Inc.