title: Reducing irinotecan-associated diarrhea in children.
abstract: Irinotecan is increasingly being used in pediatric oncology. Amelioration of diarrhea associated with protracted irinotecan administration may reduce morbidity and improve dose intensity. In this review, we discuss what is known about the pathogenesis of this toxicity as well as potential predisposing genetic factors. We comprehensively summarize the literature regarding available prevention and treatment strategies, and report data on the use of cephalosporin prophylaxis in 51 patients treated on various pediatric trials. This approach is feasible in children and allows for tolerance of higher doses of protracted irinotecan.
authors.affiliation: Division of Pediatric Hematology/Oncology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA. Lars.wagner@cchmc.org
authors.forename: Lars M
authors.initials: LM
authors.lastname: Wagner
authors.forename: Kristine R
authors.initials: KR
authors.lastname: Crews
authors.forename: Clinton F
authors.initials: CF
authors.lastname: Stewart
authors.forename: Carlos
authors.initials: C
authors.lastname: Rodriguez-Galindo
authors.forename: Rene Y
authors.initials: RY
authors.lastname: McNall-Knapp
authors.forename: Karen
authors.initials: K
authors.lastname: Albritton
authors.forename: Alberto S
authors.initials: AS
authors.lastname: Pappo
authors.forename: Wayne L
authors.initials: WL
authors.lastname: Furman
mesh_terms: D000972:Antineoplastic Agents, Phytogenic / Q000009:adverse effects* / Q000627:therapeutic use; D002166:Camptothecin / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D002511:Cephalosporins / Q000627:therapeutic use; D002648:Child; D003967:Diarrhea / Q000139:chemically induced* / Q000235:genetics / Q000517:prevention & control*; D020022:Genetic Predisposition to Disease; D006801:Humans; D000077146:Irinotecan
chemical_list: D000972:Antineoplastic Agents, Phytogenic; D002511:Cephalosporins; D000077146:Irinotecan; D002166:Camptothecin