Onkologie. 2009:3(4):224-226

Renal toxicity of high cummulative doses of ifosfamide in patients with Ewing sarcoma/PNET

Lucia Kútniková², Michal Kýr², MUDr. Peter Múdry², Andrea Fabryová¹, MUDr. Tomáš Kepák², prof. MUDr. Jaroslav Štěrba Ph.D²

¹ Lékařská fakulta Masarykovy univerzity, 6. ročník studia, obor všeobecné lékařství

² Klinika dětské onkologie LF MU a FN, Brno

Overall survival in pediatric oncology patients with Ewing sarcoma/primitive neuroectodermal tumor correlates with cumulative doses

of alkylating agents. Especially high doses of ifosfamide, one of those alkylating agents, induce renal impairments that are caused by its

toxic metabolites. Renal toxicity in patients suffering from ES/PNET is the subject of interest mainly due to the need for many concomitant

nephrotoxic drugs during the treatment. Total of 20 patients on EE 99 protocol who received cumulative dose of ifosfamide above 60 g/

m2 were included in this observational retrospective study. Renal toxicity was determined on the basis of glomerular filtration (GF) rate,

tubular functions and minimal signs of Fanconi syndrome. We found significant decrease in GF using Schwartz´s formula (p = 0.001). Half

of the patients developed minimal signs of Fanconi syndrome. Regardless of the fact that the post treatment values did not reach grade

3 and 4 toxicity according to Common Toxicity Criteria of Adverse Events (CTCAE), significant renal impairment was detected.

Keywords: Ewing sarcoma/PNET, ifosfamide, renal functions, toxicity.

Published: November 1, 2009  Show citation