年龄对异环磷酰胺所致肾毒性的影响。

Influence of age upon Ifosfamide-induced nephrotoxicity.

作者信息

McCune Jeannine S, Friedman Debra L, Schuetze Scott, Blough David, Magbulos Madonna, Hawkins Douglas S

机构信息

University of Washington Medical Center, Seattle, Washington, USA.

出版信息

Pediatr Blood Cancer. 2004 May;42(5):427-32. doi: 10.1002/pbc.20011.

DOI:10.1002/pbc.20011

PMID:15049014

Abstract

BACKGROUND

Ifosfamide-induced nephrotoxicity is well recognized in children, although it has also been reported in adults. Whether ifosfamide nephrotoxicity is more common in children than in adults is not known.

PROCEDURE

Medical records of adults and children diagnosed with sarcoma whom received ifosfamide with a cumulative dose >20 g/m(2) were evaluated. Twenty-five children (</=18-years of age) and 28 adults were identified.

RESULTS

National Cancer Institute Common Toxicity Criteria grade 3-4 ifosfamide-induced nephrotoxicity was present in 24 and 17% of children and adults, respectively (P = 0.58). Cumulative ifosfamide doses were similar between the two populations, with the median (range) of 70.2 g/m(2) (22.4-72) for children and 59 g/m(2) (20.8-146) for adults (P = 0.25). Logistic regression analysis indicated that neither age or cumulative ifosfamide dose were associated with grade 3-4 ifosfamide-induced nephrotoxicity (P = 0.36).

CONCLUSIONS

Children and adults receiving >20 g/m(2) of ifosfamide have similar susceptibility to ifosfamide-induced nephrotoxicity. Factors other than age and cumulative dose should be considered for understanding the inter-individual variation in nephrotoxicity.

摘要

背景

异环磷酰胺所致肾毒性在儿童中已得到充分认识，尽管在成人中也有相关报道。尚不清楚异环磷酰胺肾毒性在儿童中是否比成人中更常见。

方法

对诊断为肉瘤且接受累积剂量>20 g/m²异环磷酰胺治疗的成人和儿童的病历进行评估。共确定了25名儿童（≤18岁）和28名成人。

结果

根据美国国立癌症研究所通用毒性标准，3-4级异环磷酰胺所致肾毒性在儿童和成人中的发生率分别为24%和17%（P = 0.58）。两组人群的异环磷酰胺累积剂量相似，儿童的中位数（范围）为70.2 g/m²（22.4 - 72），成人为59 g/m²（20.8 - 146）（P = 0.25）。逻辑回归分析表明，年龄和异环磷酰胺累积剂量均与3-4级异环磷酰胺所致肾毒性无关（P = 0.36）。