Late effects of chemotherapeutic agents on renal function in childhood cancer survivors: a review of the literature

O’Sullivan, Donnchadh

doi:10.1007/s11845-016-1473-z

Cited by 15 publications

(14 citation statements)

References 18 publications

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“…It can lead to rickets and growth impairment and has been described as occurring in 5 to 7% of paediatric patients treated with ifosfamide. 2,6 Our patient presented with metabolic acidosis, hypophosphatemia, hypokalemia, hypouricemia, proteinuria and glycosuria. Further testing showed low tubular reabsorption of phosphorus and high fractional excretion of potassium and uric acid, thus confirming the diagnosis of Fanconi syndrome.…”

Section: Discussionmentioning

confidence: 95%

“…5 It has been described as a late effect of Ifosfamide in only 5 to 7% of patients treated. 2,6 In this case report the authors describe a case of Fanconi syndrome diagnosed 17 months after exposure to ifosfamide for Burkitt lymphoma treatment.…”

Section: Introductionmentioning

confidence: 99%

“…However, it is associated with nephrotoxicity in up to 50% of patients, depending on the screening method. 1,2 Ifosfamide nephrotoxicity may manifest abruptly or subclinically and belatedly several months or years after exposure, with different degrees of severity, ranging from asymptomatic tubulopathy to overt renal failure. [1][2][3] Important metabolic consequences include acidosis and electrolyte disorders, with the need for complex supplementation therapy, decreased quality of life, and also limitations on optimal antineoplastic treatment of relapses.…”

Section: Introductionmentioning

confidence: 99%

“…1,2 Ifosfamide nephrotoxicity may manifest abruptly or subclinically and belatedly several months or years after exposure, with different degrees of severity, ranging from asymptomatic tubulopathy to overt renal failure. [1][2][3] Important metabolic consequences include acidosis and electrolyte disorders, with the need for complex supplementation therapy, decreased quality of life, and also limitations on optimal antineoplastic treatment of relapses. 4 Fanconi syndrome is a proximal tubulopathy characterized by proximal tubular loss of glucose, phosphate, bicarbonate, amino acid and proteins which may result in rickets and growth impairment.…”

Section: Introductionmentioning

confidence: 99%

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Fanconi syndrome after Ifosfamide exposure – case report

Gomes

García

Francisco

et al. 2019

pjnh

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Ifosfamide is an antineoplastic drug widely used in the treatment of paediatric malignancies. However, in up to 50% of patients, it is associated with nephrotoxicity ranging from asymptomatic tubulopathy to overt renal failure. A two-year-old Caucasian boy was diagnosed with stage IV Burkitt lymphoma, with hepatic and renal and bone marrow involvement. Baseline evaluation showed GFR of 60 mL/min/1.73 m 2. He started chemotherapy with LMB 96 protocol group B with 5 courses of chemotherapy with vincristine, cyclophosphamide, doxorubicin, prednisone, and intrathecal administration of cytarabine and methotrexate. After the first chemo protocol, the patient was in remission and recovered normal renal function, but three months later he relapsed with involvement of the liver and kidneys. The patient initiated a salvage regimen with RICE (rituximab-ifosfamide, carboplatin, etoposide) intrathecal methotrexate and cytarabine and allogeneic stem cell transplantation was proposed. After achieving complete remission, he underwent allogeneic stem cell transplantation with busulfan and cyclophosphamide. Graft versus host disease prophylaxis was made with tacrolimus and methotrexate and infection prophylaxis with fluconazole and acyclovir. However, during treatment of the relapse, the patient presented downward crossing of weight and height centiles without recovery after treatment terminus and, following transplantation, consecutive laboratory testing suggested tubulopathy. Upon nephrologist referral, he was diagnosed with Fanconi syndrome and adequate supplementation was initiated with improvement of the patient's general condition and slow centile catch up. After literature review, the most probable causing agent was determined to be ifosfamide, as the nephrotoxic effects of the other medications prescribed tend to be reversible after stopping. Nephrotoxicity secondary to chemotherapy is a major cause of morbidity in paediatric cancer survivors. Our case represents a rare situation with unspecific clinical signs. Clinicians must be alert to the necessity of close monitoring to identify renal toxicity, mainly tubular dysfunction, as early as possible and allow adequate supplementation, which is crucial in preventing side effects.

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Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Fanconi syndrome after Ifosfamide exposure – case report

Gomes

García

Francisco

et al. 2019

pjnh

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“…Childhood cancer patients face additional health risks due to exposure to radiation and chemotherapy during early life growth and development. Recent literature reviews reported the following late adverse effects childhood cancer: increased risk of subsequent primary malignancies, hypothyroidism, severe fatigue, hearing loss organ dysfunctions (ovarian, liver, lungs, heart, kidney and bladder), obesity as well as musculoskeletal, dental and psychosocial effects [15][16][17][18][19][20][21]. The Australian healthcare system consists of both public and private providers.…”

Section: Introductionmentioning

confidence: 99%

Lifetime Costs of Surviving Cancer—A Queensland Study (COS-Q): Protocol of a Large Healthcare Data Linkage Study

Merollini

Gordon

Aitken

et al. 2020

IJERPH

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Australia-wide, there are currently more than one million cancer survivors. There are over 32 million world-wide. A trend of increasing cancer incidence, medical innovations and extended survival places growing pressure on healthcare systems to manage the ongoing and late effects of cancer treatment. There are no published studies of the long-term health service use and cost of cancer survivorship on a population basis in Australia. All residents of the state of Queensland, Australia, diagnosed with a first primary malignancy from 1997–2015 formed the cohort of interest. State and national healthcare databases are linked with cancer registry records to capture all health service utilization and healthcare costs for 20 years (or death, if this occurs first), starting from the date of cancer diagnosis, including hospital admissions, emergency presentations, healthcare costing data, Medicare services and pharmaceuticals. Data analyses include regression and economic modeling. We capture the whole journey of health service contact and estimate long-term costs of all cancer patients diagnosed and treated in Queensland by linking routinely collected state and national healthcare data. Our results may improve the understanding of lifetime health effects faced by cancer survivors and estimate related healthcare costs. Research outcomes may inform policy and facilitate future planning for the allocation of healthcare resources according to the burden of disease.

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