Ifosfamide-induced neurotoxicity: a case report and review of the literature.
OBJECTIVE
To review published abstracts, journal articles, and case reports for evidence of ifosfamide-induced neurotoxicity in both adult and pediatric populations.


METHODS
Peer-reviewed journal articles (October 1985 through August 1990) obtained through a computer literature search, with subsequent bibliography scanning.


METHODS
We identified 34 reports that specifically addressed neurotoxicity related to ifosfamide therapy. By consensus of the authors, 8 of these reports were excluded due to a small study population, duplication of age of data.


METHODS
Studies were assessed by the first author and verified by the second author. Several colleagues also contributed to the analysis.


METHODS
Risk factors and mechanisms behind this potentially fatal neurotoxic reaction remain speculative and, in some cases, contradictory. The predictive capability of a published nomogram is restricted by differences in dosage regimens and encephalopathic classifications. Currently, the best prevention against neurotoxicity is little or no use of concurrent medications that have central nervous system effects.


CONCLUSIONS
Further studies should address the influence of other nephrotoxic agents (e.g., cisplatin, aminoglycosides) on the incidence of ifosfamide-induced neurotoxicity.
Miller
L J
LJ
Division of Pharmacy, University of Texas M.D. Anderson Cancer Center, Houston 77030.
Eaton
V E
VE
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002493:Central Nervous System Diseases / Q000139:chemically induced*; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage / Q000009:adverse effects*; D007262:Infusions, Intravenous; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
D007069:Ifosfamide