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Carboplatin (CBDCA), iproplatin (CHIP), and high dose cisplatin in hypertonic saline evaluated for tubular nephrotoxicity

  • Original Articles
  • Carboplatin, Iproplatin, High Dose Cisplatin, Nephrotoxicity
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Summary

We compared the acute tubular nephrotoxicity of three platinum compounds in children and adults with solid tumors by monitoring the urinary excretion of alanine aminopeptidase, N-acetyl-β-D-glucosaminidase, and total protein. Cisplatin (100 mg/m2) was administered with mannitol, or at a twofold larger total dosage (50 mg/m2 per day for 4 days) in a 3% saline infusion. Carboplatin (300 mg/m2) was administered in combination with 5-fluorouracil, and iproplatin was administered in dosages ranging from 216 to 388 mg/m2. Enzymuria and proteinuria induced by cisplatin at a total dosage of 200 mg/m2 on a divided schedule did not significantly differ from that observed for the single 100 mg/m2 dose. Enzymuria and proteinuria induced by carboplatin and iproplatin were significantly less than that for cisplatin; however, one patient developed chronic tubular damage after three courses of carboplatin, and the acute tubular toxicity of iproplatin in one of 15 patients was exceptional. Our findings support the value of administering cisplatin in hypertonic saline on a divided schedule as a strategy to reduce acute tubular damage. Although carboplatin and iproplatin are less nephrotoxic than cisplatin, occasionally patients experience subclinical acute or chronic tubular damage that may lead to overt nephrotoxicity with continued therapy.

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Authors and Affiliations

  1. The Department of Pathology and Laboratory Medicine, St. Jude Children's Research Hospital, Memphis, Tennessee, USA

    Marshall P. Goren & Reba K. Wright

  2. Department of Hematology-Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA

    Marc E. Horowitz & Charles B. Pratt

  3. Division of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee, USA

    Richard K. Dodge

  4. Department of Pediatrics, University Tennessee Center Health Sciences, Memphis, Tennessee, USA

    Marc E. Horowitz & Charles B. Pratt

  5. The Department of Internal Medicine, Division of Hematology-Oncology, University of Michigan Medical Center, Ann Arbor, Michigan, USA

    Arlene A. Forastiere

  6. The Department of Pediatrics and Pharmacology, University of Texas Health Sciences Center, Dallas, Texas, USA

    Barton A. Kamen

Authors
  1. Marshall P. Goren
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  2. Arlene A. Forastiere
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  3. Reba K. Wright
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  4. Marc E. Horowitz
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  5. Richard K. Dodge
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  6. Barton A. Kamen
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  7. Mary J. Viar
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  8. Charles B. Pratt
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Additional information

Supported in part by Biomedical Research Support grant RR05584 (MPG), Cancer Center Support (CORE) grant CA-21765, Childhood Solid Tumor Program Project grant CA-23099, American Lebanese Syrian Associated Charities and NCI N01-CM-07405

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Goren, M.P., Forastiere, A.A., Wright, R.K. et al. Carboplatin (CBDCA), iproplatin (CHIP), and high dose cisplatin in hypertonic saline evaluated for tubular nephrotoxicity. Cancer Chemother. Pharmacol. 19, 57–60 (1987). https://doi.org/10.1007/BF00296257

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  • DOI: https://doi.org/10.1007/BF00296257

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