Analysis of the clinical characteristics of pediatric patients who experience ifosfamide-induced encephalopathy
Analysis of the clinical characteristics of pediatric patients who experience ifosfamide-induced encephalopathy
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异环磷酰胺脑病患儿临床特征分析
DOI：
10.1002/pbc.27996
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发表时间：
2019
影响因子：
3.2
通讯作者：
Yuichiro Ide
中科院分区：
文献类型：
--
作者：
Kumazaki H;Muramatsu T;Kobayashi K;Watanabe T;Terada K;Higashida H;Yuhi T;Mimura M;Kikuchi M.;橋本直明;Yuichiro Ide
研究背景异环磷酰胺（IFO）等化疗方案治疗多种儿科血液病和/或恶性肿瘤。IFO诱导的脑病（IIE）是严重的副作用之一，但没有足够的证据关于IIE在children.ProcedureWe的临床特征进行了回顾性研究，在一个单一的中心与化疗方案，包括IFO治疗的儿科患者。我们记录了所有患者的临床特征，我们比较了谁开发IIE和那些没有的患者之间的临床特征。ResultsIn总数，88例患者接受了化疗方案，包括IFO。7例患者（8.0%）发生IIE。在年轻人群中，发生IIE时患者的中位年龄为4.3岁（范围1.4 - 6.5）。7例IIE患者中有6例仅通过支持治疗改善;然而，1例患者因心力衰竭死亡。两组的总生存率没有差异。多变量分析显示，顺铂（CDDP）或卡铂（CBDCA）联合给药是与IIE相关的显著风险因素。虽然化疗前组之间的实验室数据没有显着差异，开发IIE的患者在几个实验室检查，包括肾和肝功能的恶化。ConclusionsRenal dysfunction caused by the combination of nephrotoxic agents（IFO和CDDP/CBDCA）似乎是重要的儿科IIE的发展。在开始化疗方案之前，根据实验室数据难以预测IIE的发作;然而，在IFO化疗方案期间仔细观察实验室数据可能有助于预测IIE的发作并促进早期治疗。
BackgroundSeveral kinds of pediatric hematological and/or malignant diseases are treated with chemotherapy regimens including ifosfamide (IFO). IFO‐induced encephalopathy (IIE) is one of the serious side effects, but there is not enough evidence regarding the clinical features of IIE in children.ProcedureWe performed a retrospective study on pediatric patients treated with chemotherapy regimens, including IFO, at a single center. We recorded the clinical characteristics of all patients; we compared the clinical characteristics between patients who developed IIE and those who did not.ResultsIn total, 88 patients received a chemotherapy regimen including IFO. IIE developed in seven patients (8.0%). The median age of patients at the time of IIE development was 4.3 (range 1.4‐6.5) years in the younger population. Six of seven patients with IIE improved with supportive therapy only; however, one patient died due to heart failure. Overall survival was not different between the two groups. Multivariable analysis revealed that the co‐administration of cisplatin (CDDP) or carboplatin (CBDCA) was a significant risk factor associated with IIE. Although there was no significant difference in laboratory data between the groups before chemotherapy, patients who developed IIE showed exacerbation in several laboratory tests, including those for renal and liver functions.ConclusionsRenal dysfunction caused by the combination of nephrotoxic agents (IFO and CDDP/CBDCA) seems to be important for the development of pediatric IIE. It was thought to be difficult to predict IIE onset based on laboratory data before the initiation of chemotherapy regimens; however, careful observation of laboratory data during IFO chemotherapy regimens may help predict IIE onset and facilitate early treatment.