Reducing irinotecan-associated diarrhea in children.
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.
Wagner
Lars M
LM
Division of Pediatric Hematology/Oncology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA. Lars.wagner@cchmc.org
Crews
Kristine R
KR
Stewart
Clinton F
CF
Rodriguez-Galindo
Carlos
C
McNall-Knapp
Rene Y
RY
Albritton
Karen
K
Pappo
Alberto S
AS
Furman
Wayne L
WL
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
D000972:Antineoplastic Agents, Phytogenic; D002511:Cephalosporins; D000077146:Irinotecan; D002166:Camptothecin