[Ifosfamide-related encephalopathy. Report of two cases].
BACKGROUND
Due to ifosfamide urotoxicity, encephalopathy is a frequent complication accompanying treatment with this drug. The various clinical, physiological and therapeutical aspects of ifosfamide-related encephalopathy are reviewed. We report two cases and review current literature.


METHODS
Ifosfamide-related encephalopathy has polymorphous and non-specific clinical picture. The disease severity is variable, as related deaths have been reported. Clinical signs disappear with treatment discontinuation. Routes of administration, doses, tumoral site and gender have been implicated in the disease physiopathology. Admittedly, metabolite mitochondrial toxicity would be the underlying mechanism. Treatment would be based on intravenous methylene blue. A clinical trial aimed at studying prophylaxis is in progress. A few number of patients have been cured until now.


CONCLUSIONS
Further studies are required to confirm the involved physiopathological mechanisms and methylene blue effects.
Dourthe
L M
LM
Service de radiothérapie et d'oncologie médicale, hôpital d'instruction des armées du Val-de-Grâce, Paris, France.
Coutant
G
G
Desrame
J
J
Merrer
J
J
Daly
J P
JP
D000328:Adult; D018906:Antineoplastic Agents, Alkylating / Q000009:adverse effects*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001927:Brain Diseases / Q000139:chemically induced*; D005260:Female; D005354:Fibrosarcoma / Q000188:drug therapy; D006338:Heart Neoplasms / Q000188:drug therapy; D006801:Humans; D007069:Ifosfamide / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000473:pathology; D010997:Pleural Neoplasms / Q000188:drug therapy
D018906:Antineoplastic Agents, Alkylating; D007069:Ifosfamide