Hearing loss and vestibular dysfunction among children with cancer after receiving aminoglycosides

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background: 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. Procedure: 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. Results: 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 1,200mg/kg, five developed toxicity. Conclusions: 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.

Original languageEnglish (US)
Pages (from-to)1772-1777
Number of pages6
JournalPediatric Blood and Cancer
Volume60
Issue number11
DOIs
StatePublished - Nov 2013

Fingerprint

Aminoglycosides
Hearing Loss
Amikacin
Neoplasms
Hearing
High-Frequency Hearing Loss
Hearing Tests
Sodium Potassium Chloride Symporter Inhibitors
Febrile Neutropenia
Platinum
Bone Marrow
Radiation
Transplants
Drug Therapy
Therapeutics
Infection

Keywords

  • Aminoglycoside
  • Late effects
  • Ototoxicity

ASJC Scopus subject areas

  • Oncology
  • Pediatrics, Perinatology, and Child Health
  • Hematology

Cite this

@article{f37a9cc8eeb449ad8e436bbe5199f52c,
title = "Hearing loss and vestibular dysfunction among children with cancer after receiving aminoglycosides",
abstract = "Background: 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. Procedure: 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. Results: 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 1,200mg/kg, five developed toxicity. Conclusions: 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.",
keywords = "Aminoglycoside, Late effects, Ototoxicity",
author = "Chen, {Kenneth S.} and Alicia Bach and Angela Shoup and Winick, {Naomi J.}",
year = "2013",
month = "11",
doi = "10.1002/pbc.24631",
language = "English (US)",
volume = "60",
pages = "1772--1777",
journal = "Pediatric Blood and Cancer",
issn = "1545-5009",
publisher = "Wiley-Liss Inc.",
number = "11",

}

TY - JOUR

T1 - Hearing loss and vestibular dysfunction among children with cancer after receiving aminoglycosides

AU - Chen, Kenneth S.

AU - Bach, Alicia

AU - Shoup, Angela

AU - Winick, Naomi J.

PY - 2013/11

Y1 - 2013/11

N2 - Background: 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. Procedure: 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. Results: 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 1,200mg/kg, five developed toxicity. Conclusions: 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.

AB - Background: 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. Procedure: 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. Results: 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 1,200mg/kg, five developed toxicity. Conclusions: 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.

KW - Aminoglycoside

KW - Late effects

KW - Ototoxicity

UR - http://www.scopus.com/inward/record.url?scp=84883777478&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84883777478&partnerID=8YFLogxK

U2 - 10.1002/pbc.24631

DO - 10.1002/pbc.24631

M3 - Article

C2 - 23788258

AN - SCOPUS:84883777478

VL - 60

SP - 1772

EP - 1777

JO - Pediatric Blood and Cancer

JF - Pediatric Blood and Cancer

SN - 1545-5009

IS - 11

ER -