Letter to the editor: Lack of protection of proximal tubular cells by amifostine (ethyol) in ifosfamide-containing regimens
✍ Scribed by de Kraker, J.; Bierings, M.B.; Offringa, M.
- Publisher
- John Wiley and Sons
- Year
- 2000
- Tongue
- English
- Weight
- 30 KB
- Volume
- 34
- Category
- Article
- ISSN
- 0098-1532
No coin nor oath required. For personal study only.
✦ Synopsis
Lack of Protection of Proximal Tubular Cells by Amifostine (Ethyol) in Ifosfamide-containing Regimens
To the Editor: Ifosfamide (IF) is an effective drug in paediatric oncology [1]. However, there is great need for agents that can deal with the dose-limiting tubular toxicity of IF.
Amifostine (Ethyol) is a prodrug that forms an activated free thiol when dephosphorylated by alkaline phosphatase. The metabolite appears to be selective in its entry into nonmalignant cells. In this way, it can protect against toxicity associated with alkylating agents and platinum-containing regimens. Preclinical studies suggested that nephrotoxicity caused by alkylating agents and organoplatinums could be prevented. Hence amifostine seemed to be a suitable drug for clinical testing in IF tubulotoxicity in the paediatric age group.
We performed a pilot study to investigate the safety of amifostine in children and to judge the efficacy of amifostine in decreasing acute tubular toxicity in patients receiving a cumulative dose of 12-18 g/m 2 of IF. Eight patients were included in this study. After having obtained informed consent, four consecutive patients