Tolerability of the cytoprotective agent amifostine in elderly patients receiving chemotherapy: a comparative study

In order to determine if age and comorbidity influence the tolerability of the cytoprotective agent amifostine, we compared side effects related to am ifostine in patients greater than or equal to 70 years (group I) with patie nts <70 years (group II). We evaluated 268 consecutive administrations of a mifostine (119 in group I and 149 in group II, respectively), given i.v. at a dose of 740 mg/m(2) just before platinum-, taxol- or cyclophosphamide-ba sed chemotherapy. Transient hypotension was the most common side effect occ urring in association with amifostine, Decreases in systolic blood pressure >20 mmHg were of similar frequency in both groups (27.1 versus 28.8% of am ifostine infusions in group I and II, respectively). Hypotension did not re sult in medical sequelae in any of the patients. The amifostine infusion wa s interrupted 16 times in group I and 8 times in group It, respectively, ma inly due to hypotension, but could be restarted after a few minutes in all patients except for three cases in group I. Patients in group II more often suffered from nausea/vomiting than in group II (20.8 versus 10.0% in group I). Other subjective symptoms (e.g. warmed, flushed sensation, sneezing, m etallic taste, mouth dryness, dizziness and sleepiness) and hypocalcemia oc curred with a similar frequency in both groups. Adverse effects associated with amifostine were not observed more frequently in elderly patients than in younger ones, although more elderly patients had a comorbidity than the younger ones. [(C) 2001 Lippincott Williams & Wilkins.].