Abstract
We investigated the renal function of pediatric and adult patients who had been submitted to chemotherapy with high-dose methotrexate (MTX), cisplatin and high-dose ifosfamide (IFO). We observed 43 osteosarcoma patients aged 4-34 years (median 16 years). The median received cumulative doses of MTX, cisplatin and IFO were 60.1 g/m2, 598 mg/m2 and 73.5 g/m2. Renal function was assessed by measurement of creatinine clearance, renal threshold for phosphate (Tmp/GFR), urinary α1-microglobulin (A1M):creatinine ratio, urinary albumin:creatinine ratio, 24-h glycosuria and proteinuria. The median interval between chemotherapy completion and first renal function assessment was 2 months (range 2-4 months); assessments were then performed at a median interval of 16 months (range 9-49 months). A significant decrease of TmP/GFR was observed only in the pediatric group (under 18 years): the percentage of patients with TmP/GFR <1 mmol/l increased from 21% (six of 28) at the end of treatment to 46% (13 of 28) at the late assessment. Glycosuria in 10 (67%) of 15 adults and 21 (75%) of pediatric patients was detected with an increased incidence compared to the early post-chemotherapy assessment (13% adults and 29% children). A significant increase of the albumin:creatinine ratio and A1M:creatinine ratio was observed only in adults. Overall, 21 patients had a reduced glomerular function at the latest evaluation, associated with glycosuria in 15 patients (71%), proteinuria in 14 (67%) and TmP/GFR <1 mmol/l in 11 (52%). We conclude that strict monitoring of renal function should be recommended in pediatric and adult patients after chemotherapy with high-dose MTX, cisplatin and high-dose IFO.
| Original language | English |
|---|---|
| Pages (from-to) | 733-738 |
| Number of pages | 6 |
| Journal | Anti-Cancer Drugs |
| Volume | 16 |
| Issue number | 7 |
| DOIs | |
| Publication status | Published - Aug 2005 |
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Keywords
- Cisplatin
- High-dose ifosfamide
- High-dose methotrexate
- Nephrotoxicity
- Osteosarcoma
ASJC Scopus subject areas
- Cancer Research
- Oncology
- Pharmacology
Cite this
Prospective evaluation of renal function in pediatric and adult patients treated with high-dose ifosfamide, cisplatin and high-dose methotrexate. / Ferrari, Stefano; Pieretti, Franca; Verri, Elisabetta; Tolentinis, Loredana; Cesari, Marilena; Versari, Michela; Zolezzi, Carola; Lamanna, Gaetano; Bacci, Gaetano.
In: Anti-Cancer Drugs, Vol. 16, No. 7, 08.2005, p. 733-738.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Prospective evaluation of renal function in pediatric and adult patients treated with high-dose ifosfamide, cisplatin and high-dose methotrexate
AU - Ferrari, Stefano
AU - Pieretti, Franca
AU - Verri, Elisabetta
AU - Tolentinis, Loredana
AU - Cesari, Marilena
AU - Versari, Michela
AU - Zolezzi, Carola
AU - Lamanna, Gaetano
AU - Bacci, Gaetano
PY - 2005/8
Y1 - 2005/8
N2 - We investigated the renal function of pediatric and adult patients who had been submitted to chemotherapy with high-dose methotrexate (MTX), cisplatin and high-dose ifosfamide (IFO). We observed 43 osteosarcoma patients aged 4-34 years (median 16 years). The median received cumulative doses of MTX, cisplatin and IFO were 60.1 g/m2, 598 mg/m2 and 73.5 g/m2. Renal function was assessed by measurement of creatinine clearance, renal threshold for phosphate (Tmp/GFR), urinary α1-microglobulin (A1M):creatinine ratio, urinary albumin:creatinine ratio, 24-h glycosuria and proteinuria. The median interval between chemotherapy completion and first renal function assessment was 2 months (range 2-4 months); assessments were then performed at a median interval of 16 months (range 9-49 months). A significant decrease of TmP/GFR was observed only in the pediatric group (under 18 years): the percentage of patients with TmP/GFR <1 mmol/l increased from 21% (six of 28) at the end of treatment to 46% (13 of 28) at the late assessment. Glycosuria in 10 (67%) of 15 adults and 21 (75%) of pediatric patients was detected with an increased incidence compared to the early post-chemotherapy assessment (13% adults and 29% children). A significant increase of the albumin:creatinine ratio and A1M:creatinine ratio was observed only in adults. Overall, 21 patients had a reduced glomerular function at the latest evaluation, associated with glycosuria in 15 patients (71%), proteinuria in 14 (67%) and TmP/GFR <1 mmol/l in 11 (52%). We conclude that strict monitoring of renal function should be recommended in pediatric and adult patients after chemotherapy with high-dose MTX, cisplatin and high-dose IFO.
AB - We investigated the renal function of pediatric and adult patients who had been submitted to chemotherapy with high-dose methotrexate (MTX), cisplatin and high-dose ifosfamide (IFO). We observed 43 osteosarcoma patients aged 4-34 years (median 16 years). The median received cumulative doses of MTX, cisplatin and IFO were 60.1 g/m2, 598 mg/m2 and 73.5 g/m2. Renal function was assessed by measurement of creatinine clearance, renal threshold for phosphate (Tmp/GFR), urinary α1-microglobulin (A1M):creatinine ratio, urinary albumin:creatinine ratio, 24-h glycosuria and proteinuria. The median interval between chemotherapy completion and first renal function assessment was 2 months (range 2-4 months); assessments were then performed at a median interval of 16 months (range 9-49 months). A significant decrease of TmP/GFR was observed only in the pediatric group (under 18 years): the percentage of patients with TmP/GFR <1 mmol/l increased from 21% (six of 28) at the end of treatment to 46% (13 of 28) at the late assessment. Glycosuria in 10 (67%) of 15 adults and 21 (75%) of pediatric patients was detected with an increased incidence compared to the early post-chemotherapy assessment (13% adults and 29% children). A significant increase of the albumin:creatinine ratio and A1M:creatinine ratio was observed only in adults. Overall, 21 patients had a reduced glomerular function at the latest evaluation, associated with glycosuria in 15 patients (71%), proteinuria in 14 (67%) and TmP/GFR <1 mmol/l in 11 (52%). We conclude that strict monitoring of renal function should be recommended in pediatric and adult patients after chemotherapy with high-dose MTX, cisplatin and high-dose IFO.
KW - Cisplatin
KW - High-dose ifosfamide
KW - High-dose methotrexate
KW - Nephrotoxicity
KW - Osteosarcoma
UR - http://www.scopus.com/inward/record.url?scp=23344449942&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=23344449942&partnerID=8YFLogxK
U2 - 10.1097/01.cad.0000168394.89428.11
DO - 10.1097/01.cad.0000168394.89428.11
M3 - Article
C2 - 16027521
AN - SCOPUS:23344449942
VL - 16
SP - 733
EP - 738
JO - Anti-Cancer Drugs
JF - Anti-Cancer Drugs
SN - 0959-4973
IS - 7
ER -