Acute renal toxicity of 2 conditioning regimens in patients undergoing autologous peripheral blood stem-cell transplantation. Total body irradiation-cyclophosphamide versus ifosfamide, carboplatin, etoposide.
OBJECTIVE
To compare acute renal toxicity of 2 conditioning regimens of total body irradiation/cyclophosphamide (TBI-Cy) and Ifosfamide, Carboplatin, and Etoposide (ICE).


METHODS
Between August 1996 and February 2004, patients treated with autologous peripheral stem cell transplantation in the Department of Medical and Radiation Oncology, Gulhane Military Medical School, Ankara, Turkey with 2 different conditioning regimens was comparatively analyzed for acute renal toxicity in the early post-transplant period. Forty-seven patients received ICE regimen with 12 g/m2; 1.2 g/m2; and 1.2 g/m2 divided to 6 consecutive days, whereas 21 patients received 12 Gy TBI (6 fractions twice daily in 3 consecutive days) and 60 mg/m2/day cyclophosphamide for 2 days.


RESULTS
Sixty-eight patients were evaluated in this study. There was no significant difference in baseline renal function between patients in the ICE and TBI-Cy groups. Eleven patients developed nephrotoxicity (23.4%) in the ICE group while one patient (4.8%) in the TBI-Cy group developed nephrotoxicity (p=0.06). Five out of 11 patients developing nephrotoxicity in ICE group required hemodialysis and subsequently 4 (8.5%) of them died. In contrast, one patient (4.8%) died due to nephrotoxicity despite hemodialysis in the TBI-Cy arm.


CONCLUSIONS
This study reveals that the TBI-Cy conditioning regimen seems no more nephrotoxic than an ICE regimen particularly in patients who had used cisplatin prior to transplantation.
Beyzadeoglu
Murat
M
Department of Radiation Oncology, Gulhane Military Medical School, Ankara, Turkey. muratbeyzadeoglu@yahoo.com
Arpaci
Fikret
F
Surenkok
Serdar
S
Ozyigit
Gokhan
G
Oysul
Kaan
K
Caglar
Kayser
K
Ataergin
Selmin
S
Yenicesu
Mujdat
M
Kaya
Ayper
A
D058186:Acute Kidney Injury / Q000209:etiology; D000328:Adult; D016190:Carboplatin / Q000008:administration & dosage / Q000009:adverse effects; D003520:Cyclophosphamide / Q000009:adverse effects; D004359:Drug Therapy, Combination; D005047:Etoposide / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage / Q000009:adverse effects; D007166:Immunosuppressive Agents / Q000009:adverse effects; D007668:Kidney / Q000187:drug effects*; D036102:Peripheral Blood Stem Cell Transplantation; D019172:Transplantation Conditioning / Q000009:adverse effects* / Q000379:methods*; D014182:Transplantation, Autologous; D014916:Whole-Body Irradiation / Q000009:adverse effects
D007166:Immunosuppressive Agents; D005047:Etoposide; D003520:Cyclophosphamide; D016190:Carboplatin; D007069:Ifosfamide