Cisplatin therapy in infants: short and long-term morbidity.
The tolerance to and toxicity of cisplatin treatment was retrospectively studied in 30 infants. A total of 191 courses were given with a median of six per child and a median cumulative dose of 400 mg m-2. Electrolyte disturbances were noted in 15/23 infants (38:144 courses): hypomagnesaemia, which was dose related, in 10/23 (25/144 courses), hyponatraemia in 6/23 (7:144 courses), hypercalcaemia in 4/23 (6/144 courses), and hypocalcaemia in 3/23 (4/144 courses). Seizures occurred in two infants. Vomiting followed 31/191 courses and neutropenic febrile episodes 23/191 courses. Median survival is 6 years 1 month. Six children have died of progressive malignancy. Glomerular filtration rate was less than 80 ml min-1 per 1.73 m2 in 15/29 children, at or within a month of the end of treatment; of ten retested at follow-up, eight had increased to more than 80 ml min-1 per 1.73 m2 (P = 0.027). High-frequency hearing loss was observed in 10/28 children, but was only significant in five (four grade 2 and one grade 3).


CONCLUSIONS
the long-term toxicity of cisplatin in infants, at this dose range and schedule, is no more severe than in older children.
Brock
P R
PR
Department of Haematology and Oncology, Hospital for Sick Children, London, UK.
Yeomans
E C
EC
Bellman
S C
SC
Pritchard
J
J
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy*; D002699:Chlorambucil / Q000008:administration & dosage; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects*; D004573:Electrolytes / Q000097:blood; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008113:Liver Neoplasms / Q000188:drug therapy*; D008297:Male; D009017:Morbidity; D009447:Neuroblastoma / Q000188:drug therapy*; D011239:Prednisolone / Q000008:administration & dosage; D012640:Seizures / Q000139:chemically induced; D013724:Teratoma / Q000188:drug therapy*; D013997:Time Factors; D014750:Vincristine / Q000008:administration & dosage
D004573:Electrolytes; D002699:Chlorambucil; D014750:Vincristine; D005047:Etoposide; D011239:Prednisolone; D002945:Cisplatin