Beyer J, Grabbe J, Lenz K, Weisbach V, Strohscheer I, Huhn D, Siegert W
Abteilung Innere Medizin, Freien Universität Berlin, Germany.
Bone Marrow Transplant. 1992 Dec;10(6):491-4.
Forty patients with germ cell tumors were treated with carboplatin 1500-2000 mg/m2, etoposide 1200-1600 mg/m2 and ifosfamide 0-10 g/m2 plus mesna followed by autologous stem cell reinfusion. A pruritic maculopapular rash was observed in 10 patients usually starting on the last day of chemotherapy. Lesions remained localized to the extremities in four patients. In six they became confluent and progressed also involving the trunk and face. Facial edema and painful swelling of hands and feet also occurred in this latter group. No ulcerations or bullae formation were seen and changes resolved spontaneously in all patients within 3 weeks leaving marked hyperpigmentation in involved areas. Renal function declined in nine of 10 patients concomitantly with evolving cutaneous changes, but recovered in all except one. Cutaneous side effects were more frequent with increasing doses of etoposide and carboplatin and in patients with deteriorating renal function. Plasma concentrations during high-dose chemotherapy should be monitored to avoid excessive serum levels and toxicity, especially in patients at risk of renal dysfunction.
40例生殖细胞肿瘤患者接受了卡铂1500 - 2000mg/m²、依托泊苷1200 - 1600mg/m²以及异环磷酰胺0 - 10g/m²加美司钠治疗，随后进行自体干细胞回输。10例患者出现瘙痒性斑丘疹，通常在化疗最后一天开始出现。4例患者的皮疹局限于四肢。6例患者的皮疹融合并进展，累及躯干和面部。后一组患者还出现面部水肿以及手足疼痛性肿胀。未见溃疡或大疱形成，所有患者的这些改变在3周内自发消退，受累部位留下明显色素沉着。10例患者中有9例肾功能随着皮肤改变的进展而下降，但除1例患者外其余均恢复。随着依托泊苷和卡铂剂量增加以及肾功能恶化，皮肤副作用更常见。应监测大剂量化疗期间的血浆浓度，以避免血清水平过高和毒性，尤其是肾功能不全风险患者。
