CLINICAL ASPECTS OF IFOSFAMIDE-INDUCED EN CEPHALOPATHY

In the application of ifosfamide, one must be prepared for an ifosfami de-induced encephalopathy. The aim of our investigation was to determi ne the incidence of this side-effect and to describe its risk factors and the clinical management as well. Among 688 chemotherapy courses co nsisting of carboplatin and ifosfamide, we have observed an ifosfamide encephalopathy in 13 cases (1.89%) which was always associated with t he risk factors alcohol anamnesis, hypalbuminemia, liver-or kidney dys function or a large tumor in the pelvis. Within the criteria of an int ensive observation, the therapy consisted mainly of a forced diuresis in combination with a correction of the fluid and electrolyte balance. First experiences with the administration of methylene blue are repor ted. Using an ifosfamide dosage of 2 g/m(2) body surface area on day 1 -3, and in consideration or exclusion of the above mentioned risk fact ors severe encephalopathies can be widely avoided.