RT Journal Article SR Electronic T1 Neuroleptic malignant syndrome in patients with cancer: a systematic review JF BMJ Supportive & Palliative Care JO BMJ Support Palliat Care FD British Medical Journal Publishing Group SP 265 OP 270 DO 10.1136/bmjspcare-2020-002200 VO 10 IS 3 A1 Izumi Sato A1 Hideki Onishi A1 Chiaki Kawanishi A1 Shuhei Yamada A1 Mayumi Ishida A1 Koji Kawakami YR 2020 UL http://spcare.bmj.com/content/10/3/265.abstract AB Background Antipsychotics potentially cause a low incidence of the side effect called neuroleptic malignant syndrome (NMS), which has a high mortality rate. However, few studies on NMS among patients with cancer exist.Aims We aimed to examine the characteristics of antipsychotic-induced NMS among patients with cancer.Methods We conducted a systematic review of published reports on NMS described during the treatment of patients with any type of cancer. Articles were identified by a comprehensive search of PubMed, Web of Science, the Cochrane Library and reference lists from relevant articles published until 25 December 2019. Original articles or case reports on humans published in English were included. This review summarises the symptoms, characteristics, treatment course and prognosis of patients with cancer with NMS.Results Eleven patients with various cancer types from ten case reports published from 1988 to 2013 met the eligibility criteria. Mean age of the 11 patients was 52.5 (range, 32–83) years. NMS developed mostly during the postoperative period, and haloperidol and D2 receptor antagonists were determined as the common causative drugs. Ten patients survived following treatment that mostly involved discontinuing the causative drugs and administering dantrolene, if necessary.Conclusion Although NMS intrinsically has a low incidence and high mortality, only few reports were available, with most patients surviving after early detection and appropriate treatment. Healthcare providers should consider NMS development while prescribing antipsychotics to ensure prompt recognition of the condition and rapid treatment for preventing unnecessary deaths.