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Palifermin in a hematopoietic stem cell transplant patient with osteonecrosis of the jaw

Eugene Applebaum College of Pharmacy and Allied Health Professions, Wayne State University, Detroit, MI, USA

Simon M Cronin, MS, PharmD

Karmanos Cancer Institute/Harper Hospital/The Detroit Medical Center, Wayne State University, Detroit, MI, USA

Edward Peres, MD

Bone Marrow Transplantation Service, Karmanos Cancer Institute and School of Medicine, Wayne State University, Detroit, MI, USA

Muneer H Abidi, MD

Bone Marrow Transplantation Service, Karmanos Cancer Institute and School of Medicine, Wayne State University, Detroit, MI, USA

Rami B Ibrahim, MSc, PharmD, BCPS, BCOP

Eugene Applebaum College of Pharmacy and Allied Health Professions, Wayne State University, Detroit, MI, USA, Karmanos Cancer Institute/Harper Hospital/The Detroit Medical Center, Wayne State University, Detroit, MI, USA

This case report describes the use of palifermin in a multiple myeloma patient with a history of osteonecrosis of the jaw (ONJ) for the prevention of high-dose chemotherapy-induced mucositis. Following the day of autologous stem cell infusion, palifermin was discontinued secondary to adverse events. Specifically, palifermin-associated macroglossia seemed to exacerbate the pain localized in the oral cavity area affected by ONJ, necessitating escalated doses of narcotic analgesics. When contemplating palifermin as a mucosal protectant in a hematopoietic stem cell transplant patient with ONJ, a careful benefit-to-risk assessment is in order to ensure optimal effectiveness without undue harm.

Key Words: palifermin • osteonecrosis of the jaw • transplantation

Journal of Oncology Pharmacy Practice, Vol. 12, No. 2, 119-121 (2006)
DOI: 10.1177/1078155206070451


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