Hi there,
One of our local physicians would appreciate some "collective" wisdom on the
following case.
Please feel free to offer any advise or comments.
Thanks,
Christine
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Hi Christine,
I have another case with unexpected lab results and wonder if you could help
with the interpretation.
This very active 45 yo lady has a long history of unresectable Liposarcoma
with extensive previous treatment and is now receiving Trabectedin and has
responded. Her last cycle of chemotherapy was accompanied by a prolonged
period of lethargy during which time she continued to train for a marathon.
Just before she was due to receive her next cycle of treatment (3 weeks after
her last treatment) a CK was done and this was elevated in the critical range.
The next day it fell almost by half. Chemotherapy was held for ~ 3 weeks and
to my surprise the CK was still above normal. The patient had not exercised
vigorously for at least a week prior to the last CK.
Values:
2014/9/3 891
2014/9/4 479
2014/10/1 221
Trabectedin is a new drug and while well tolerated to this point in this
patient it has been associated with Rhabdomyolysis - occasionally fatal.
The patient has no clinical findings to suggest Rhabdomyolysis apart from
general lethargy and she was also undertaking intensive exercise in
preparation for a marathon.
I was hoping you could comment on the timing of the elevation of the CK's, the
failure to normalize over a period of a month and the potential role of
exercise in the above abnormalities.
I very much appreciate any help you can provide.
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C. Collier, PhD FCACB,
Clinical Chemistry,
Kingston General Hospital,
Professor, Dept Pathology & Molecular Medicine,
Queen's University
PHONE 613-549-6666 (ext 4137)
PAGER 613-536-7571
CELL 613-541-8055
FAX 613-548-2513
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