Ifosfamide may be safely used in patients with end stage renal disease on hemodialysis Journal Article
| Authors: | Flombaum, C. D.; Latcha, S.; Maki, R. G.; Schwartz, G. K. |
| Article Title: | Ifosfamide may be safely used in patients with end stage renal disease on hemodialysis |
| Abstract: | Background. Pharmacokinetic data on clearance of ifosfamide in hemodialysis patients are limited. Consequently, these patients are excluded from therapy with this agent. We review the outcomes for patients at our institution with end stage renal disease on dialysis who received ifosfamide for metastatic sarcoma. Patients and Methods. We treated three patients with end stage renal disease on hemodialysis with escalating doses of ifosfamide. Data on radiographic response to therapy, WBC and platelet counts, signs or symptoms of infection, neuropathy and bladder toxicity are reported. Starting doses of ifosfamide were based on review of the literature available with subsequent modifications based on each patient's prior exposure to myelosuppressive agents and on symptoms of neurotoxicity and the degree of myelosuppression following each cycle of chemotherapy. Results. Myelosuppression was the most common side effect from therapy, but no patient developed a life threatening infection, neurotoxicity, or hematuria. One patient developed epistaxis in the setting of thrombocytopenia while on warfarin therapy. All patients had clinical evidence for therapeutic response and two had documented radiographic improvement following ifosfamide administration. Conclusion. Ifosfamide can be used safely in combination with hemodialysis in patients with end stage renal disease. Copyright © 2009. |
| Keywords: | adult; treatment outcome; treatment response; aged; clinical feature; disease course; neutropenia; case report; doxorubicin; drug safety; side effect; treatment duration; neurotoxicity; nuclear magnetic resonance imaging; metastasis; infection; multiple cycle treatment; bone marrow suppression; tumor volume; thrombocytopenia; sedation; dexamethasone; kidney failure; hematuria; ifosfamide; drug dose escalation; sarcoma; warfarin; thrombocyte count; granisetron; glucose; seizure; leukocyte count; tumor growth; granulocyte colony stimulating factor; metoclopramide; epistaxis; hemodialysis; irritability; neuropathic pain; tremor |
| Journal Title: | Sarcoma |
| Volume: | 2009 |
| ISSN: | 1357-714X |
| Publisher: | Hindawi Publishing Corporation |
| Date Published: | 2009-01-01 |
| Start Page: | epub |
| Language: | English |
| DOI: | 10.1155/2009/575629 |
| PROVIDER: | scopus |
| PMCID: | PMC2804110 |
| PUBMED: | 20107495 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 30 November 2010" - "Art. No.: 575629" - "CODEN: SARCF" - "Source: Scopus" |
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