Combined chemotherapy and teratogenicity

• Published in: Birth defects research. A Clinical and molecular teratology 2005-09, Vol.73 (9), p.634-637
• Main Authors: Paskulin, Giorgio Adriano, Gazzola Zen, Paulo Ricardo, de Camargo Pinto, Louise Lapagesse, Rosa, Rafael, Graziadio, Carla
• Format: Article
• Language: English
• Subjects: Abnormalities, Drug-Induced - diagnostic imaging; Abnormalities, Drug-Induced - etiology; Abnormalities, Drug-Induced - pathology; Abnormalities, Multiple - chemically induced; Abnormalities, Multiple - diagnostic imaging; Abnormalities, Multiple - pathology; Adult; Antibiotics, Antineoplastic - toxicity; Antimetabolites, Antineoplastic - toxicity; Antineoplastic Agents, Alkylating - toxicity; Antineoplastic Combined Chemotherapy Protocols - toxicity; Biological and medical sciences; birth defect; Breast Neoplasms - drug therapy; chemotherapy; Child, Preschool; Cyclophosphamide - toxicity; Developmental Disabilities - chemically induced; Doxorubicin - toxicity; Drug Therapy, Combination; Drug toxicity and drugs side effects treatment; Embryology: invertebrates and vertebrates. Teratology; Female; Fluorouracil - toxicity; Fundamental and applied biological sciences. Psychology; Humans; Male; malformation; Maternal-Fetal Exchange - drug effects; Medical sciences; Microcephaly - chemically induced; Miscellaneous (drug allergy, mutagens, teratogens...); Pharmacology. Drug treatments; Pregnancy; Pregnancy Complications, Neoplastic - drug therapy; Pregnancy Complications, Neoplastic - etiology; Pregnancy Trimester, Third; Radiography; Syndactyly - diagnostic imaging; Syndactyly - etiology; teratogenesis; Teratogens - toxicity; Teratology. Teratogens
• ISSN: 1542-0752; 1542-0760
• DOI: 10.1002/bdra.20180

BACKGROUND The concomitant occurrence of breast cancer and pregnancy is relatively uncommon. We report the case of a patient with syndactyly, cleft hands, and absence of distal finger phalanges associated with maternal exposure to chemotherapeutic agents during the first trimester of pregnancy. These associations have not been previously described. CASE The patient was born by normal delivery after 38 weeks of pregnancy. His mother became pregnant while receiving chemotherapy (cyclophosphamide, 5‐fluorouracil, and adriamycin) for breast cancer, and the fetus was exposed to these drugs from conception to the 16th week of pregnancy. At birth, anomalies were observed, including a high‐arched palate, microcephaly, a flat nasal bridge, bilateral syndactyly in the first and second fingers with a hand cleft between the second and third fingers and hypoplasia of the fifth fingers, and dystrophic nail of the fourth finger of the left hand. The patient's growth and development were deficient. CONCLUSIONS The malformations associated with in utero exposure to these chemotherapeutic agents are highly variable, but growth deficiency and anomalies of the craniofacial region and limbs are the most common. The pattern of malformations in children who were congenitally exposed to chemotherapeutic agents appears to be directly related to the age at and duration of exposure, rather than to the specific drug itself. Effective contraception is essential for the safe use of a potential teratogen in nonpregnant women of reproductive age. Birth Defects Research (Part A), 2005. © 2005 Wiley‐Liss, Inc.