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Renal toxicity with cumulative doses of cis‐diamminedichloroplatinum‐II in pediatric patients with osteosarcoma. Effect on creatinine clearance and methotrexate excretion
Author(s) -
Jaffe Norman,
Iii Robert Keifer,
Robertson Resa,
Cangir Ayten,
Wang Alexander
Publication year - 1987
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19870501)59:9<1577::aid-cncr2820590908>3.0.co;2-p
Subject(s) - medicine , toxicity , cumulative dose , renal function , creatinine , methotrexate , diuresis , urology , nephrotoxicity , mannitol , pharmacology , chemistry , organic chemistry
Sequential corrected creatinine clearance (CCC) evaluations were obtained in 30 patients treated with intra‐arterial and/or intravenous cis‐diamminedichloroplatinum‐II (CDP). The dose was 150 mg/M 2 administered with mannitol diuresis at 2 to 3 weekly intervals. Four hundred fifty‐three courses were administered (range, 6–18) over 18 months. Patients also were treated with 283 courses of high‐dose methotrexate (MTX) and citrovorum factor “rescue” which were interposed between treatments. Deleterious effects of cumulative courses of CDP manifested as progressive reductions in CCC and delayed excretion of serum MTX. Severe MTX toxicity was aborted by augmenting the fluid intake and prolonging citrovorum factor rescue when elevated levels of serum MTX were detected. The first indication of renal induced CDP toxicity occurred with a cumulative dose of 450 mg/M 2 . At the termination of treatment (cumulative CDP dose over 1050 mg/M 2 ) renal impairment still was present.