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High-dose carboplatin, etoposide and melphalan (CEM) with peripheral blood progenitor cell support as late intensification for high-risk cancer: non-haematological, haematological toxicities and role of growth factor administration.

The present report describes the non-haematological toxicity and the influence of growth factor administration on haematological toxicity and haematopoietic recovery observed after high-dose carboplatin (1200 mg m(-2)), etoposide (900 mg m(-2)) and melphalan (100 mg m(-2)) (CEM) followed by peripheral blood progenitor cell transplantation (PBPCT) in 40 patients with high-risk cancer during their first-line treatment. PBPCs were collected during the previous outpatient induction chemotherapy programme by leukaphereses. CEM administration with PBPCT was associated with low non-haematological tox

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… A phase I study of high-dose ifosfamide and escalating doses of carboplatin with autologous bone marrow support. J Clin Oncol. 1991 Feb;9(2):320–327. doi: 10.1200/JCO.1991.9.2.320. Elias A. D., Ayash L. … High dose chemotherapy with ifosfamide, carboplatin, and etoposide combined with autologous bone marrow transplantation for the treatment of poor-prognosis germ cell tumors and metastatic trophoblastic disease in adults. …

Near-precise interchromosomal recombination and functional DNA topoisomerase II cleavage sites at MLL and AF-4 genomic breakpoints in treatment-related acute lymphoblastic leukemia with t(4;11) translocation.

We analyzed the der(11) and der(4) genomic breakpoint junctions of a t(4;11) in the leukemia of a patient previously administered etoposide and dactinomycin by molecular and biochemical approaches to gain insights about the translocation mechanism and the relevant drug exposure. The genomic breakpoint junctions were amplified by PCR. Cleavage of DNA substrates containing the normal homologues of the MLL and AF-4 translocation breakpoints was examined in vitro upon incubation with human DNA topoisomerase IIalpha and etoposide, etoposide catechol, etoposide quinone, or dactinomycin. The der(11)

Clinical review: specific aspects of acute renal failure in cancer patients.

Acute renal failure (ARF) in cancer patients is a dreadful complication that causes substantial morbidity and mortality. Moreover, ARF may preclude optimal cancer treatment by requiring a decrease in chemotherapy dosage or by contraindicating potentially curative treatment. The pathways leading to ARF in cancer patients are common to the development of ARF in other conditions. However, ARF may also develop due to etiologies arising from cancer treatment, such as nephrotoxic chemotherapy agents or the disease itself, including post-renal obstruction, compression or infiltration, and metabolic o

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… Alkylating agents The main anticancer agents responsible for haemorrhagic cystitis are alkylating agents, such as cyclophosphamide and ifosfamide. … Moreover, ifosfamide has been associated with ARF or acute tubular dysfunction [ 40 ]. In a paediatric study, up to 22% of patients experienced either ARF or Fanconi syndrome [ 40 ]. …

Chemotherapy-induced acute kidney injury: epidemiology, pathophysiology, and therapeutic approaches.

Despite significant advancements in oncology, conventional chemotherapy remains the primary treatment for diverse malignancies. Acute kidney injury (AKI) stands out as one of the most prevalent and severe adverse effects associated with these cytotoxic agents. While platinum compounds are well-known for their nephrotoxic potential, other drugs including antimetabolites, alkylating agents, and antitumor antibiotics are also associated. The onset of AKI poses substantial risks, including heightened morbidity and mortality rates, prolonged hospital stays, treatment interruptions, and the need for

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… Ifosfamide Ifosfamide (IFO) is a chemotherapeutic agent analogous to cyclophosphamide, employed in the treatment of various solid tumors, including sarcomas. … The use of reduced doses of amifostine to ameliorate nephrotoxicity of cisplatin/ifosfamide-based chemotherapy in patients with solid tumors. Anticancer Drugs. (2000) 11:1–6. doi: 10.1097/00001813-200001000-00001 82. Koukourakis M. …

Kidney Biopsy Findings Among Allogenic Hematopoietic Stem Cell Transplant Recipients With Kidney Injury: A Case Series.

RATIONALE AND OBJECTIVE: The incidence of kidney disease is high in patients after allogeneic hematopoietic cell transplantation (aHCT). Although rarely performed, kidney biopsy may be useful to make a precise diagnosis because several mechanisms and risk factors can be involved, and to adjust the treatment accordingly. This case series aimed to report the spectrum of biopsy findings from patients with kidney injury after aHCT. STUDY DESIGN: Single-center retrospective case series. SETTING AND PARTICIPANTS: All individuals who underwent a native kidney biopsy, among all adult patients who re

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… On contrary, many cases of AKI and Fanconi syndrome with ifosfamide, an alkylating agent similar to cyclophosphamide, have been described in the recent literature. 50 , 51 , 52 Pathologic findings found in ifosfamide-induced AKI have been described as karyomegalic-like interstitial nephropathy in 2 case … Partial Fanconi Syndrome Induced by Ifosfamide Cureus 11 1 2019 e3947 10.7759/cureus.3947 PMC6433442 30937245 51 Stöhr W. Paulides M. Bielack S. …

Rhabdomyosarcoma: Current Therapy, Challenges, and Future Approaches to Treatment Strategies.

Rhabdomyosarcoma is a rare cancer arising in skeletal muscle that typically impacts children and young adults. It is a worldwide challenge in child health as treatment outcomes for metastatic and recurrent disease still pose a major concern for both basic and clinical scientists. The treatment strategies for rhabdomyosarcoma include multi-agent chemotherapies after surgical resection with or without ionization radiotherapy. In this comprehensive review, we first provide a detailed clinical understanding of rhabdomyosarcoma including its classification and subtypes, diagnosis, and treatment str

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… Ifosfamide Ifosfamide is also a nitrogen mustard derivative that was developed as a structural isomer of cyclophosphamide in the 1960s. … Ifosfamide can also cause a greater degree of urotoxicity compared to cyclophosphamide, thus co-administration of mesna is recommended [ 111 ]. Compared to cyclophosphamide, which is taken orally, ifosfamide is given intravenously [ 112 ]. …

DNA Damaging Drugs

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… Whereas both cyclophosphamide and ifosfamide are activated by Cytochromes P450 2B1 and 2C6/2C11, only ifosfamide is also activated by Cytochrome P450 3A. Fig. 2.6 CYP450 catalyzed metabolism of ifosfamide and cyclophosphamide via the 4-hydroxylation pathway. … Ifosfamide produces less myelotoxicity (mainly leukopenia) than cyclophosphamide and also exhibits little cross-resistance. The metabolic ifosfamide product acrolein can contribute to the hemorrhagic cystitis associated with oxazaphosphorine therapy. …

Exploring antiemetic strategies in hematologic malignancies: a comprehensive literature review and evaluation of antiemetic efficacy in patients receiving high-dose chemotherapy prior to hematopoietic stem cell transplantation.

PURPOSE: Most antiemetic studies have been conducted in patients with solid tumors receiving single-dose chemotherapy. A research gap leaves healthcare providers without clear guidance on effective antiemetic regimens and schedules for patients with hematologic malignancies undergoing high-dose multiday chemotherapy. This literature search identified antiemetic studies and assessed efficacy outcomes in the hematology setting, and specifically in patients receiving high-dose chemotherapy prior to hematopoietic stem cell transplantation (HSCT). METHODS: A literature review of both PubMed and Em

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… + carboplatin + etoposide; Ida/Ara-C , idarubicin + cytarabine; IVE , ifosfamide + epirubicin + etoposide; R-DHAOX , rituximab + dexamethasone + high-dose cytarabine + oxaliplatin; MCVAC , ranimustine + etoposide + cytarabine + cyclophosphamide; MEAM , ranimustine + etoposide + cytarabine + melphalan … + carboplatin + etoposide; Ida/Ara-C , idarubicin + cytarabine; IVE , ifosfamide + epirubicin + etoposide; R-DHAOX , rituximab + dexamethasone + high-dose cytarabine + oxaliplatin; MCVAC , ranimustine + etoposide + cytarabine + cyclophosphamide; MEAM , ranimustine + etoposide + cytarabine + melphalan …

Five-year remission without disease progression in a patient with relapsed/refractory multiple myeloma with extramedullary disease treated with LCAR-B38M chimeric antigen receptor T cells in the LEGEND-2 study: a case report.

BackgroundMultiple myeloma remains incurable despite treatment advancements over the last 20 years. LCAR-B38M Cells in Treating Relapsed/Refractory Multiple Myeloma was a phase 1, first-in-human, investigator-initiated study in relapsed/refractory multiple myeloma conducted at four sites in China. The study used LCAR-B38M chimeric antigen receptor-T cells expressing two B-cell maturation antigen-targeting single-domain antibodies designed to confer avidity, and a CD3ζ signaling domain with a 4-1BB costimulatory domain to optimize T-cell activation and proliferation. This chimeric antigen recep

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… Subsequently, the patient received five cycles of VAD as consolidation chemotherapy; one cycle of cisplatin, etoposide, ifosfamide, and dexamethasone (DCEP); one cycle of lenalidomide, cyclophosphamide, and dexamethasone (RCD); and then lenalidomide 10 mg once daily as maintenance therapy. … CAR, chimeric antigen receptor; CR, complete response; DCEP, cisplatin, etoposide, ifosfamide, and dexamethasone; IFE, immunofixation; MRD, minimal residual disease; QD, once daily; RCD, lenalidomide, cyclophosphamide, and dexamethasone; VAD, vinorelbine, pirarubicin, and dexamethasone On 4 June 2016 …

Vinorelbine--a clinical review.

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… Cisplatin-vindesine-mitomycin (MVP) vs cisplatin-ifosfamide-vinorelbine (PIN) vs carboplatin-vinorelbine (CaN) in patients with advanced non-small-cell lung cancer (NSCLC): a FONICAP randomized phase II study. Italian Lung Cancer Task Force (FONICAP). … A review of ifosfamide and vinorelbine in advanced non-small cell carcinoma of the lung. Semin Oncol. 1998 Feb;25(1 Suppl 2):8–14. Morris M., Brader K. R., Levenback C., Burke T. W., Atkinson E. N., Scott W. R., Gershenson D. M. …

Hypophosphatemia in cancer patients.

Dysregulation of phosphorus homeostasis resulting in hypophosphatemia is common in cancer patients and can result in serious complications and impact outcomes. Several factors, including critical illness, nutritional status, cancer type and therapy, influence the development of hypophosphatemia. Hypophosphatemia can develop as a result of phosphaturic mesenchymal tumors or as a paraneoplastic phenomenon. The clinical presentation for hypophosphatemia varies depending on the duration and severity of the hypophosphatemia and affects several organ systems. Among other serious effects, hypophospha

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… Risk factors for nephrotoxicity and hypophosphatemia include a cumulative dose of ifosfamide >60 g/m 2 , young age and pretreatment with cisplatin. Furthermore, hypophosphatemia might persist or even develop months after cessation of ifosfamide therapy [ 55 ]. … Long-term evaluation of Ifosfamide-related nephrotoxicity in children . J Clin Oncol 2009 ; 27 : 5350 – 5355 19826134 10.1200/JCO.2008.17.5257 54 Lee BS , Lee JH , Kang HG et al . Ifosfamide nephrotoxicity in pediatric cancer patients . …

Arrhythmias, conduction disorders and sudden cardiac death in cancer patients and survivors: expert opinion of the working groups on cardio-oncology and on electrophysiology of the hellenic cardiac society.

Advances in cancer therapeutics have significantly improved patient survival; however, cardiotoxic effects-including arrhythmias-have emerged as a growing clinical concern. This expert opinion, developed by the Working Groups on Cardio-Oncology and Electrophysiology of the Hellenic Cardiological Society, aims to raise awareness of the increasing burden of arrhythmias in cancer patients and survivors. This document explores the multifactorial etiology of arrhythmias in this population, including patient-related factors, the direct effects of malignancy, and the arrhythmogenic potential of thera

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… Table 4 Types of arrhythmias induced by cancer therapeutics [ 8 , 49 , 64 , 65 ] Type of arrhythmias /electrical impairment | Cancer therapeutics Atrial fibrillation | Alkylating agents (cisplatin, cyclophosphamide, ifosfamide, melphalan, dacarbazine, 4-hydroperoxycyclophosphamide) Antiandrogen (abiraterone … Table 5 Drug-drug interactions between anticancer therapies and anticoagulation therapy [ 41 ] Anticoagulation therapy | Cancer therapeutics | Type of interaction Apixaban | AKL TKI (brigatinib, ceritinib crizontinib, lorlatinib) Alkaloid (irinotecan, topotecan) Alkylating agent (ifosfamide) ANT (etoposide …

Strategies for selecting/switching chemotherapy and supportive care treatments during COVID-19 outbreak.

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… Oral mesna can be given to replace IV mesna at 4 hours and 8 hours after ifosfamide administration to shorten the total time required in the infusion room. 10 Convert short‐acting to long‐acting medications. … IV on Days 1‐4 of AIM regimen | Cisplatin IV Day 1 + Etoposide IV Day 1, oral etoposide Days 2‐3 Mesna IV at 0 hour, PO at 4 and 8 hours post ifosfamide IV on Days 1‐4 of AIM regimen | Reduce clinical visit frequency Reduce duration of visits Convert short‐acting to long‐acting medications | Filgrastim …

Ten Наводки на биопсию почек у больных раком.

Ренальная биопсия — это важный диагностический инструмент, который следует учитывать у больных раком, население которого часто страдает почечной дисфункцией, многофакторной и клинической активностью. Точное выявление основных повреждений часто имеет решающее значение для руководства онкологической терапией, предотвращения дальнейшего упадка почечной железы и улучшения общих результатов. Однако проведение биопсии в этой уязвимой группе пациентов требует тщательной оценки процедурных рисков и клинического контекста. Это...10 Брошюра < < Советы > > обеспечивает практическую основу для

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… KIN after ifosfamide) | Renal injury clearly attributable to known chemotherapy toxicity with typical clinical course 8. … With respect to conventional chemotherapy, ifosfamide [ 69 ] and methotrexate [ 70 ] are considered major risk factors for AKI. …

Urinary Beta-2-Microglobulin and Late Nephrotoxicity in Childhood Cancer Survivors.

The objectives of this study were to evaluate urinary beta-2-microglobulin (β2M) levels in long-term childhood cancer survivors and to establish its association with anticancer drug-induced nephrotoxicity. The study consisted of 165 childhood cancer survivors (CCS) who were in continuous complete remission. We reported that CCS had a significantly higher level of β2M (p < 0.001) and β2M/Cr. ratio (p < 0.05) than healthy peers. Among all participants, 24 (14.5%) had decreased eGFR (<90 mL/min/1.73 m2). A significant positive correlation between β2M/Cr. ratio and body mass index (coef. 14.48, p

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… Moreover, no correlations between the β2M level and β2M/Cr. ratio, and the cumulative dose of cyclophosphamide, ifosfamide, cisplatin, and methotrexate were found ( p > 0.05). … The greater risk of nephrotoxicity was observed in survivors given ifosfamide and cisplatin, and with nephrectomy [ 18 , 19 ]. In the present study, no such relationship was noted. …

Cancer Therapy-Induced Encephalitis.

Encephalitis associated with cancer therapies is a rare but serious complication that can significantly impact patients' quality of life and it requires prompt identification and management. Over the past two decades, immunotherapy-particularly immune checkpoint inhibitors-has become a cornerstone of cancer treatment, with up to half of metastatic cancer patients in economically developed countries now receiving these therapies. The widespread adoption of immunotherapy has led to improved survival rates and long-term remissions, even in patients with advanced metastatic disease. However, as im

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… Methylene blue, administered at a dose of 50 mg IV every 4 h, has been used successfully in the treatment of ifosfamide-induced encephalopathy, where it is thought to act as an alternative electron acceptor [ 84 ]. Ifosfamide and its metabolites are thought to interfere with thiamine functions. … Methylene Blue in the Treatment and Prevention of Ifosfamide-Induced Encephalopathy: Report of 12 Cases and a Review of the Literature. Br. J. Cancer. 2000;82:291–294. doi: 10.1054/bjoc.1999.0917. 85. Hamadani M., Awan F. Role of Thiamine in Managing Ifosfamide-Induced Encephalopathy. J. Oncol. …

Prediction of cancer drugs by chemical-chemical interactions.

Cancer, which is a leading cause of death worldwide, places a big burden on health-care system. In this study, an order-prediction model was built to predict a series of cancer drug indications based on chemical-chemical interactions. According to the confidence scores of their interactions, the order from the most likely cancer to the least one was obtained for each query drug. The 1(st) order prediction accuracy of the training dataset was 55.93%, evaluated by Jackknife test, while it was 55.56% and 59.09% on a validation test dataset and an independent test dataset, respectively. The propos

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… Ifosfamide-Cancers of haematopoietic and lymphoid tissues Ifosfamide ( D00343 ) can be used to treat germ cell testicular cancer, cervical cancer, small cell lung cancer, non-Hodgkin’s lymphoma, and so on [36] . … And Moskowitz et al. also reported that ICE regimen (ifosfamide, carboplatin, and etoposide) was effective for patients with non-Hodgkin’s lymphoma [61] . …

Micronutrients in Oncological Intervention.

Nutritional supplements are widely used among patients with cancer who perceive them to be anticancer and antitoxicity agents. Depending on the type of malignancy and the gender 30%-90% of the cancer patients supplement their diets with antioxidant and immuno-stabilizing micronutrients, such as selenium, vitamin C, and vitamin D, often without the knowledge of the treating physician. From the oncological viewpoint, there are justifiable concerns that dietary supplements decrease the effectiveness of chemotherapy and radiotherapy. Recent studies, however, have provided increasing evidence that

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… Ifosfamide can also cause considerable renal loss of l -carnitine. Chloracetaldehyde, the metabolite of ifosfamide, may be oxidized to chloroacetic acid, which then binds to free CoA. … Increased mitochondrial toxicity of cisplatin and ifosfamide. Increased risk of fatigue [ 164 ] as well as of cisplatin- and ifosfamide-induced adverse neurotoxic and cardiotoxic effects. …

Critical considerations in the administration of antineoplastic therapy for patients with malignant solid tumors undergoing hemodialysis.

Patients with chronic kidney disease exhibit a higher risk of developing malignancies, and among those with end-stage renal disease (ESRD) on dialysis, approximately 7% are diagnosed with new-onset tumors within five years. Patients with ESRD who are receiving antineoplastic treatment exhibit a significantly higher incidence and greater severity of adverse effects associated with antineoplastic agents compared to individuals with normal renal function. This complexity involves multiple factors, including the therapy options and dose adjustment of antineoplastic agents, drug-related toxicities,

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… In vitro studies suggest that hemodialysis can decrease ifosfamide concentrations by 87% and chloracetaldehyde by 77%. … Notably, both CTX and ifosfamide are associated with increased bladder toxicity, thereby elevating the risk of urinary system malignancies ( 80 ). …

A decision-analytic approach to define poor prognosis patients: a case study for non-seminomatous germ cell cancer patients.

BackgroundClassification systems may be useful to direct more aggressive treatment to cancer patients with a relatively poor prognosis. The definition of 'poor prognosis' often lacks a formal basis. We propose a decision analytic approach to weigh benefits and harms explicitly to define the treatment threshold for more aggressive treatment. This approach is illustrated by a case study in advanced testicular cancer, where patients with a high risk of mortality under standard treatment may be eligible for high-dose chemotherapy with stem cell support, which is currently defined by the IGCC class

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… Several non-randomised trials reported a higher survival for poor prognosis patients treated with HD-CT as first line treatment (including etoposide, ifosfamide, cisplatin) with autologous stem cell support, compared to standard-dose chemotherapy (SD-CT) (including bleomycin, etoposide, cisplatin) [ … A RCT comparing standard dose bleomycin-etoposide-cisplatin (BEP) with standard dose etoposide-ifosfamide-cisplatin (VIP) reported a 5-year overall survival of 60% for 181 poor prognosis patients [ 13 ]. …