Chemotherapy with cytosine arabinoside in a child with Burkitt's lymphoma on maintenance hemodialysis and hemofiltration.
A case of Burkitt's lymphoma (stage IV) in an 8-year-old boy with end-stage renal failure due to hemolytic uremic syndrome is reported. The boy was treated by maintenance hemodialysis (HD) and hemofiltration (HF). During chemotherapy treatment with continuous cytosine arabinoside (Ara-C) infusion (100 mg/m2/d) for 7 days, concentrations of Ara-C and its metabolite uracil arabinoside (Ara-U) were measured in blood, dialysate, and filtrate. Ara-C levels were always below 200 ng/ml and were only qualitatively detectable in blood, dialysate, and filtrate. Ara-U levels were higher than 200 ng/ml after 18 h treatment and were measured quantitatively. Ara-U clearance during 3 h HD was 92 ml/min and the calculated mass removal 14.7 mg/3 h. In contrast, the Ara-U clearance during 3 h HF was 14 ml/min and the mass removal was 6.7 mg/3 h. Ara-C and Ara-U are eliminated by HD and HF in anuric patients. A continuous infusion of 100 mg Ara-C m2/d during HD or HF treatment did not result in a serum concentration above 200 ng/ml.
Pöschl
J M
JM
Department of Pediatrics University of Heidelberg, Germany.
Klaus
G
G
Querfeld
U
U
Ludwig
R
R
Mehls
O
O
D001086:Arabinofuranosyluracil / Q000097:blood; D002051:Burkitt Lymphoma / Q000150:complications / Q000188:drug therapy*; D002648:Child; D003561:Cytarabine / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D006440:Hemofiltration; D006801:Humans; D007262:Infusions, Intravenous; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy; D008297:Male; D006435:Renal Dialysis; D014466:Ultraviolet Rays
D003561:Cytarabine; D001086:Arabinofuranosyluracil