Hearing loss and vestibular dysfunction among children with cancer after receiving aminoglycosides. Issue 11 (20th June 2013)

• Record Type: Journal Article
• Authors: Chen, Kenneth S.; Bach, Alicia; Shoup, Angela; Winick, Naomi J.
• Is Part Of: Pediatric blood & cancer. Volume 60:Issue 11(2013:Nov.)
• Page Start: 1772
• Page End: 1777
• Publication Date: 2013-06-20
• Subjects: Tumors in children -- Periodicals; Blood -- Diseases -- Periodicals; Cancer in children -- Periodicals; 618.92
• DOI: 10.1002/pbc.24631
• Languages: English
• ISSNs: 1545-5009

Abstract

<abstract abstract-type="main" xml:lang="en"> <title>ABSTRACT</title> <sec id="pbc24631-sec-0001" sec-type="section"> <title>Background</title> <p>Children undergoing cancer therapy often receive aminoglycosides to treat febrile neutropenia or gram‐negative infections. The magnitude of the risk of developing aminoglycoside‐induced ototoxicity and the dose threshold at which that risk significantly increases are unknown.</p> </sec> <sec id="pbc24631-sec-0002" sec-type="section"> <title>Procedure</title> <p>Eligible cancer patients received the aminoglycoside amikacin at Children's Medical Center between 2004 and 2007. They were aged 3–8 years; were without prior hearing loss; had no platinum‐based chemotherapy, cranial radiation, nor bone marrow transplant; and received no loop diuretics within 6 weeks of testing. Consenting patients underwent complete hearing and vestibular testing.</p> </sec> <sec id="pbc24631-sec-0003" sec-type="section"> <title>Results</title> <p>We tested 23 patients who had significant amikacin exposure. Three (13%) had abnormal hearing tests, and four (17%) had subclinical vestibular dysfunction; none had both. Of those with hearing loss, two were known to have developed hearing loss after aminoglycoside exposure, but the third had moderate to severe high‐frequency sensorinueral hearing loss bilaterally that had been undiagnosed. We observed clear dose‐dependent ototoxicity; of the eight patients who received amikacin for a cumulative total of more than 50 days, five (68%) developed toxicity. Similarly, of the seven who received a cumulative total of more than 1, 200 mg/kg, five developed toxicity.</p> </sec> <sec id="pbc24631-sec-0004" sec-type="section"> <title>Conclusions</title> <p>These data highlight the risks of prolonged aminoglycoside administration and warrant further validation in a larger group of patients. Patients to be treated with prolonged aminoglycoside therapy may benefit from prospective hearing screening. Pediatr Blood Cancer 2013;60:1772–1777. © 2013 Wiley Periodicals, Inc.</p> </sec> </abstract>