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Successful clozapine continuation during chemotherapy for the treatment of malignancy: a case report

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Abstract

Case

The need for chemotherapy treatment in a cancer patient who uses clozapine raises a clinical dilemma because both therapies can cause agranulocytosis. A 45-year-old male diagnosed with schizophrenia used clozapine together with zuclopenthixol for more than 15 years. Non-Hodgkin’s lymphoma was treated with chemotherapy twice, and clozapine was continued during both courses of chemotherapy. Agranulocytosis did not occur during the first treatment. During the second treatment, agranulocytosis occurred, but was attributed to chemotherapy, and blood counts recovered spontaneously. Successful concomitant use of clozapine and cancer chemotherapy is based on a limited number of case reports. However, two case reports describe persistent neutropenia or agranulocytosis, possibly related to this combination.

Conclusion

Clozapine should only be continued during cancer chemotherapy if favoured by the risk-to-benefit ratio.

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Acknowledgments

Anne-Marie Doppen is kindly acknowledged for providing the drug information during chemotherapeutic treatment.

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Authors and Affiliations

  1. Department of Pharmaceutical Sciences, University of Utrecht, P.O. Box 80082, 3508 TB, Utrecht, The Netherlands

    Marloes R. Overbeeke

  2. Department of Hospital Pharmacy, Albert Schweitzer Hospital, P.O. Box 444, 3300 AK, Dordrecht, The Netherlands

    Marieke M. Beex-Oosterhuis

  3. Yulius Mental Health Institution, P.O. Box 753, 3300 AT, Dordrecht, The Netherlands

    Ellen Graveland, Jannie N. den Hoed-van Wijk & Arthur R. Van Gool

Authors
  1. Marloes R. Overbeeke
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  2. Marieke M. Beex-Oosterhuis
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  3. Ellen Graveland
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  4. Jannie N. den Hoed-van Wijk
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  5. Arthur R. Van Gool
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Corresponding author

Correspondence to Marieke M. Beex-Oosterhuis.

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Overbeeke, M.R., Beex-Oosterhuis, M.M., Graveland, E. et al. Successful clozapine continuation during chemotherapy for the treatment of malignancy: a case report. Int J Clin Pharm 38, 199–202 (2016). https://doi.org/10.1007/s11096-016-0268-7

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  • DOI: https://doi.org/10.1007/s11096-016-0268-7

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