Toxicity of oral adjuvant chemotherapy in breast cancer.

Le résumé fourni par la source

Cutaneous necrotising vasculitis induced by levamisoleThe anthelmintic agent levamisole has immunostimulant properties in patients with defective cell-mediated immune responses.We are assessing the drug in patients with breast cancer to see whether it can maintain surgically induced remission.One such patient developed a severe cutaneous necrotising vasculitis, which disappeared once the drug was withdrawn.Case report A 59-year-old woman had been receiving thrice-weekly levamisole 150 mg/day for three months, when in May 1975 she developed fever and a severe rash.Cutaneous necrotising vasculitis was diagnosed.Biopsy of one of the lesions showed intense neutrophil and eosinophil infiltration of the vessel wall with obliteration of the lumen.There were no other physical abnormalities, and no sign of the original disease was noted.She had not been taking any other drugs.Haemoglobin was 13 g/dl and white cell count 3 0 x 109/1 (3000/mm3; 30 % segmented neutrophils, 8 0o eosinophils, 10 Po monocytes, 52 ° lymphocytes).Results of complement studies were within normal limits, and other immunological and biochemical values were normal.A bone-marrow aspirate showed a normal distribution of white and red cells but a moderate increase in eosinophils.A chest radiograph was normal.Levamisole was discontinued and the patient given a short course of prednisone 40 mg daily.After two weeks the clinical picture returned to normal, and three months later the skin lesions showed no signs of recurrence and the white cell count was normal.

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