Acute rhabdomyolysis after concurrent administration of interleukin-2, interferon-alfa, and chemotherapy for metastatic melanoma

Abstract

Acute rhabdomyolysis has been described to occur only rarely after systemic administration of cancer chemotherapy drugs, such as cytarabine and 5-azafluorene. A single case of rhabdomyolysis after treatment with alfa-interferon recently was reported, but to the authors' knowledge, there have been no published cases of clinically relevant rhabdomyolysis after systemic therapy with the other agents. The case of a 28-year-old woman with metastatic melanoma and no known history of neuromuscular disorders who developed severe myalgia followed by acute, extensive rhabdomyolysis with multiorgan failure after concurrent administration of systemic biologic therapy and chemotherapy consisting of alfa-interferon, interleukin-2, cisplatin, vinblastine, and dacarbazine is described. The patient sustained considerable morbidity requiring hemodialysis and respiratory support but eventually recovered. Review of the literature revealed no reported cases of acute rhabdomyolysis after the systemic administration of these agents with the exception of alfa-interferon. Acute rhabdomyolysis should be considered when evaluating patients receiving similar biochemotherapy regimens, particularly for those regimens that are alfa-interferon-based and for patients who develop myalgia along with evidence of multiorgan failure.