IFOSFAMIDE NEPHROTOXICITY IN PEDIATRIC CANCER-PATIENTS

Ifosfamide is an alkylating agent which has been incorporated into fro ntline therapy for a number of malignant paediatric tumours. Recent da ta appears to suggest that tubular dysfunction may result from incorpo ration of this drug into chemotherapy schedules and that toxicity may be dose related. A detailed investigation of renal function was perfor med in a group of patients, ranging in age from 8 months to 15.9 years (median 8.6 years) with rhabdomyosarcoma (n = 11) and Ewing's sarcoma (n = 9) who were currently receiving (n = 4) or had completed ifosfam ide (n = 16) therapy a mean of 16 months at the time of study. All but one patient demonstrated some degree of renal dysfunction and toxicit y did not necessarily appear to be dose related. Implications for inco rporation of this agent into future schedules for childhood sarcomas, which can expect to cure more than 60% of such children, must be addre ssed. The importance of ongoing monitoring is emphasised.