Journal of Clinical Oncology, Vol 8, 1399-1401, Copyright © 1990 by American Society of Clinical Oncology
Ifosfamide neurotoxicity is related to previous cisplatin treatment for pediatric solid tumors
CB Pratt, MP Goren, WH Meyer, B Singh and RK Dodge
Departments of Hematology-Oncology, St Jude Children's Research Hospital, Memphis, TN 38101-0318.
Neurotoxicity developed in 22 of 97 children and adolescents with malignant
solid tumors treated within a phase II ifosfamide protocol. The occurrence
of neurotoxicity was related to previous cumulative dosages of cisplatin.
One third of the patients who had received more than 600 mg/m2 of cisplatin
developed this complication. The relative risk increased 3.2-fold with
previous cisplatin dosages above 301 to 600 mg/m2, and 4.1-fold with
dosages of 601 to 1,340 mg/m2. The increased risk of neurotoxicity in
patients who had received more than 600 mg/m2 of cisplatin may be related
to either a decreased clearance of ifosfamide itself or of the drug's
active metabolites.