Raynaud's Phenomenon: A Common Toxicity After Combination Chemotherapy for Testicular Cancer

Abstract

Raynaud''s phenomenon occurred in 22 of 60 men (37%) treated with vinblastine and bleomycin with or without cisplatin for germ cell testicular cancer. An additional 6 patients (10%) had symptoms suggestive of Raynaud''s phenomenon. Patients with and without Raynaud''s phenomenon did not differ with respect to median age; tumor histology; total doses of vinblastine, bleomycin and cisplatin; or the frequency of vinblastine-induced neuropathy and bleomycin-induced cutaneous toxicity. Digital ischemia occurred in 21% of patients treated with only vinblastine and bleomycin, and in 41% of patients treated also with cisplatin. Cigarette smoking was commoner in patients with, than in those without, Raynaud''s phenomenon. Hand arteriograms showed diffuse arterial narrowing and abrupt vascular cutoffs. Except for 1 patient with a very low titer of cold agglutinins, no patient had detectable antinuclear antibody, rheumatoid factor, cryoglobulins or cold agglutinins. Raynaud''s phenomenon is a common delayed toxicity after chemotherapy with vinblastine, bleomycin and cisplatin in patients with germ cell neoplasms.