Kauffman C A, Frame P T
Antimicrob Agents Chemother. 1977 Feb;11(2):244-7. doi: 10.1128/AAC.11.2.244.
Bone marrow toxicity occurred in 4 of 15 patients treated with 5-fluorocytosine (5-FC) for serious fungal infections. The development of marrow toxicity appeared to be related to serum 5-FC levels of 125 mug/ml or greater. In three patients, accumulation of toxic levels of 5-FC was related to diminished renal function. One patient with acute renal failure and prolonged high levels of 5-FC developed marrow aplasia and died of bacterial sepsis. Three patients experienced leukopenia, which was readily reversed when the dosage of 5-FC was decreased and the serum concentration was lowered. With careful monitoring of serum 5-FC concentration and renal function, the dose-related toxic effects of 5-FC on the marrow can be avoided.
15名因严重真菌感染接受5-氟胞嘧啶（5-FC）治疗的患者中有4名出现了骨髓毒性。骨髓毒性的发生似乎与血清5-FC水平达到或高于125微克/毫升有关。在3名患者中，5-FC毒性水平的积累与肾功能减退有关。1名患有急性肾衰竭且5-FC水平长期居高不下的患者发生了骨髓再生障碍，并死于细菌性败血症。3名患者出现白细胞减少，当5-FC剂量减少且血清浓度降低时，白细胞减少情况迅速得到逆转。通过仔细监测血清5-FC浓度和肾功能，可以避免5-FC对骨髓的剂量相关毒性作用。
