Reversible ageusia associated with romidepsin therapy

Purpose. The case of a patient who reported the complete loss of his sense of taste after about 3.5 months of romidepsin therapy is presented. Summary. A man with a 12-year history of treatment-refractory cutaneous T-cell lymphoma (CTCL) developed taste disturbances progressing to ageusia (the absence of taste perception) while receiving romidepsin therapy. He reported a metallic taste during the first round of romidepsin therapy (14 mg/m(2) given as a four-hour infusion on days 1, 8, and 15 of each four-week cycle); during the ninth infusion, he reported the complete loss of taste sensations. The patient chose to continue romidepsin therapy because of a favorable overall response but requested a reduced frequency of infusions due to unabated ageusia. After implementation of a revised administration schedule (infusions only on days 1 and 8 of each cycle), the man gradually regained his sense of taste, with complete reversal of ageusia once romidepsin use was discontinued after two more cycles. The application of the algorithm of Naranjo et al. to this case yielded a score of 6, indicating a probable association between the taste disturbances and romidepsin use. A literature search identified no other reports of romidepsin-associated ageusia. Conclusion. A 67-year-old man reported ageusia during the third cycle of romidepsin therapy for CTCL. Taste sensation began to slowly recover following a reduction in the frequency of romidepsin administration, but therapy was ultimately discontinued partly due to the impact of this adverse reaction on the patient's quality of life.