title: [Effect of amifostine on reducing acute toxicity of megachemotherapy of tumors in children].
abstract: BACKGROUND
  Amifostine (WR-2721, Ethyol) is a chemoprotective agent. There is little experiences with amifostine application in megachemotherapy in children. We evaluated amifostine effect on the reduction of the acute toxicity.
  
  
  RESULTS
  Retrospective comparison of patients who received amifostine with the control group (72 vs. 72). Amifostine 750 mg/m2 was given 15 minute before cytostatic dose and regularly each eight hours if we administered cytostatics continuously. Megachemotherapy schedule included melfalan, carboplatin, cyklophosphamid, vepesid, busulfan, thiotepa and karmustin. Type of graft: peripheral stem cells 56 vs. 29, bone marrow 8 vs. 30, combination 8 vs. 13. Nonhematological toxicity: mucositis p = 0.047, hepatotoxicity p < 0.001, nephrotoxicity p = 0.005. Hematological toxicity: engraftment D + 12 vs. D + 15 (p < 0.001), amount of erythrocyte transfusions 3 vs. 6 (p < 0.001), platelet transfusions 7 vs. 9 (p = 0.06), days when number of platelets reaches 20,000 without substitution D + 15 vs. D + 22 (p < 0.001). The only statistically difference was in the in total amount of platelets (p = 0.032), when we calculated patients, who received peripheral stem cells. Number of hospitalization days 14 vs. 18 (p = 0.016), days with antibiotics 14 vs. 18 (p = 0.016), number of febrile days 6 vs. 7 (p = 0.51).
  
  
  CONCLUSIONS
  Amifostine reduces mucosal, liver and kidney damage. The graft type could affect hematological results.
authors.affiliation: Klinika dĕtské onkologie 2. LF UK a FNM, Praha. jarmilavalkova@yahoo.com
authors.forename: J
authors.initials: J
authors.lastname: Válková
authors.forename: J
authors.initials: J
authors.lastname: Stanková
authors.forename: P
authors.initials: P
authors.lastname: Kavan
authors.forename: E
authors.initials: E
authors.lastname: Kabícková
authors.forename: P
authors.initials: P
authors.lastname: Gajdos
authors.forename: J
authors.initials: J
authors.lastname: Koutecký
mesh_terms: D000293:Adolescent; D004999:Amifostine / Q000008:administration & dosage*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D020011:Protective Agents / Q000008:administration & dosage*; D012189:Retrospective Studies
chemical_list: D020011:Protective Agents; D004999:Amifostine