Ifosfamide-related encephalopathy: report of two eases.

Introduction. - Due to ifosfamide urotoxicity, encephalopathy is a frequent complication accompanying treatment with this drug. The various clinical, physiological and therapeutical aspects of ifosfamide-related encephalopath y are reviewed. We report two cases and review current literature. Exegesis. - Ifosfamide-related encephalopathy has polymorphous and non-spec ific clinical picture. The disease severity is variable, as related deaths have been reported. Clinical signs disappear with treatment discontinuation . Routes of administration, doses, tumoral site and gender have been implic ated in the disease physiopathology. Admittedly metabolite mitochondrial to xicity would be the underlying mechanism. Treatment would be based on intra venous methylene blue. A clinical trial aimed at studying prophylaxis is in progress. A few number of patients have been cured until now. Conclusion. - Further studies are required to confirm the involved physioph athological mechanisms and methylene blue effects. (C) 1999 Elsevier, Paris .