Subject: Dihydropyrimidine Dehydrogenase (DPD) Deficiency Puts Patients at Grave Risk When Treated with Fluoropyrimidines
Rarely, unexpected, severe toxicity (e.g., stomatitis, diarrhea, neutropenia and
neurotoxicity) associated with 5-fluorouracil has been attributed to deficiency of
dihydropyrimidine dehydrogenase activity. A few patients have been rechallenged with 5-
fluorouracil and despite 5-fluorouracil dose lowering, toxicity recurred and
progressed with worse morbidity. Absence of this catabolic enzyme appears to
result in prolonged clearance of 5-fluorouracil.
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