title: Topotecan disposition in an anephric child.
abstract: Although limited data are available about topotecan disposition in patients with renal insufficiency, nothing has been reported in anephric patients. The objective of this report is to characterize topotecan disposition in an anephric child with Wilms tumor, both on and off hemodialysis. The patient received topotecan and cyclophosphamide for four cycles; topotecan was administered daily for 5 days, with hemodialysis on the second and fourth day. Therapy was well tolerated, with grade 3 thrombocytopenia and grade 2 neutropenia noted after cycle four. The median topotecan lactone clearance was 15.5 L/h/m off hemodialysis and 18.7 L/h/m on hemodialysis. Topotecan clearance was minimally affected by hemodialysis and was similar to that observed in children without renal failure.
authors.affiliation: Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee 38105, USA.
authors.forename: Lisa C
authors.initials: LC
authors.lastname: Iacono
authors.forename: Denise
authors.initials: D
authors.lastname: Adams
authors.forename: Alan C
authors.initials: AC
authors.lastname: Homans
authors.forename: Ann
authors.initials: A
authors.lastname: Guillot
authors.forename: Jeannine S
authors.initials: JS
authors.lastname: McCune
authors.forename: Clinton F
authors.initials: CF
authors.lastname: Stewart
mesh_terms: D000970:Antineoplastic Agents / Q000493:pharmacokinetics*; D002648:Child; D003520:Cyclophosphamide / Q000008:administration & dosage; D004791:Enzyme Inhibitors / Q000493:pharmacokinetics*; D006801:Humans; D007680:Kidney Neoplasms / Q000188:drug therapy / Q000378:metabolism*; D008297:Male; D006435:Renal Dialysis; D051437:Renal Insufficiency / Q000378:metabolism*; D059004:Topoisomerase I Inhibitors; D019772:Topotecan / Q000493:pharmacokinetics*; D009396:Wilms Tumor / Q000188:drug therapy / Q000378:metabolism*
chemical_list: D000970:Antineoplastic Agents; D004791:Enzyme Inhibitors; D059004:Topoisomerase I Inhibitors; D019772:Topotecan; D003520:Cyclophosphamide