Drug Safety

, Volume 32, Issue 12, pp 1109–1122 | Cite as

Cisplatin Overdose

Toxicities and Management
  • Roger Y. Tsang
  • Turki Al-Fayea
  • Heather-Jane AuEmail author
Practical Drug Safety


Cisplatin is one of the most widely used antineoplastic agents in the treatment of solid tumour and haematological malignancies, including cancers of the testes, ovary, bladder, head and neck, oesophagus, stomach and lung, as well as lymphoma and osteosarcoma. Its non-specific targeting commonly results in adverse effects and toxicities affecting the gastrointestinal, renal, neurological and haematological systems even when administered at standard doses. Since cisplatin-related toxicities are dose-dependent, these may be more pronounced in the setting of a cisplatin overdose, resulting in significant morbidity and/or mortality. The incidence of cisplatin overdoses is unknown; however, early-phase clinical trials utilizing high-dose cisplatin, and case reports in the overdose setting have characterized the clinical features associated with cisplatin overdoses, highlighting some therapeutic strategies for consideration.

To date, no published guidelines exist for managing a cisplatin overdose. The major toxicities of a cisplatin overdose include nausea and vomiting, renal insufficiency, electrolyte abnormalities, myelosuppression, ototoxicity, peripheral neuropathy, hepatotoxicity and retinopathy. Diarrhoea, pancreatitis, seizures and respiratory failure have also been reported. No specific antidote for cisplatin exists. Key management principles and strategies to lessen toxicities include renoprotection and enhancing drug elimination with aggressive intravenous hydration with or without the use of an osmotic diuretic, and avoidance of nephrotoxic medications. Sodium thiosulfate and plasmapheresis, with or without haemodialysis support, should be strongly considered. Close monitoring of clinical and laboratory parameters, and institution of supportive therapies, including antiemetics and haematopoietic colony stimulating factor support, are warranted. Based on the current literature, experimental therapies such as amifostine, ditiocarb sodium (diethyldithiocarbamate), acetylcysteine, fosfomycin and colestipol are of limited clinical effectiveness and remain investigational.

This review serves to highlight the clinical spectrum of toxicities resulting from a cisplatin overdose, to critically appraise the available literature and to present a suggested algorithmic approach for the initial management of a cisplatin overdose.


Clin Oncol Amifostine Fosfomycin Colestipol Rasburicase 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Pike IM, Arbus MH. Cisplatin overdosage. J Clin Oncol 1992 Sep; 10(9): 1503–4PubMedGoogle Scholar
  2. 2.
    Pourrat X, Antier D, Crenn I, et al. A prescription and administration error of cisplatin: a case report. Pharm World Sci 2004 Apr; 26(2): 64–5PubMedCrossRefGoogle Scholar
  3. 3.
    Rosenberg B, Vancamp L, Krigas T. Inhibition of cell division in Escherichia coli by electrolysis products from a platinum electrode. Nature 1965 Feb 13; 205: 698–9PubMedCrossRefGoogle Scholar
  4. 4.
    Zwelling LA, Anderson T, Kohn KW. DNA-protein and DNA interstrand cross-linking by cis- and transplatinum(II) diamminedichloride in L1210 mouse leukemia cells and relation to cytotoxicity. Cancer Res 1979 Feb; 39 (2 Pt 1): 365–9PubMedGoogle Scholar
  5. 5.
    Pinto AL, Lippard SJ. Binding of the antitumor drug cisdiamminedichloroplatinum(II) (cisplatin) to DNA. Biochim Biophys Acta 1985; 780(3): 167–80PubMedGoogle Scholar
  6. 6.
    Eastman A. Reevaluation of interaction of cis-dichloro(ethylenediamine)platinum(II) with DNA. Biochemistry 1986 Jul 1; 25(13): 3912–5PubMedCrossRefGoogle Scholar
  7. 7.
    Reed E. Cisplatin, carboplatin and oxaliplatin. In: Chabner B, Longo D, editors. Cancer chemotherapy and biotherapy: principles and practice. Philadelphia (PA): Lippincott Williams & Wilkins, 2006: 332–43Google Scholar
  8. 8.
    Corden BJ, Fine RL, Ozols RF, et al. Clinical pharmacology of high-dose cisplatin. Cancer Chemother Pharmacol 1985; 14(1): 38–41PubMedCrossRefGoogle Scholar
  9. 9.
    Sweetman S. Martindale: the complete drug reference. London: Pharmaceutical Press, 2008 [online]. Available from URL: [Accessed 2009 Oct 21]
  10. 10.
    Jacobs C, Kalman SM, Tretton M, et al. Renal handling of cis-diamminedichloroplatinum(II). Cancer Treat Rep 1980; 64(12): 1223–6PubMedGoogle Scholar
  11. 11.
    Casper ES, Kelsen DP, Alcock NW, et al. Platinum concentrations in bile and plasma following rapid and 6-hour infusions of cis-dichlorodiammineplatinum(II). Cancer Treat Rep 1979 Nov–Dec; 63(11–12): 2023–5PubMedGoogle Scholar
  12. 12.
    Belt RJ, Himmelstein KJ, Patton TF, et al. Pharmacokinetics of non-protein-bound platinum species following administration of cis-dichlorodiammineplatinum(II). Cancer Treat Rep 1979 Sep–Oct; 63(9–10): 1515–21PubMedGoogle Scholar
  13. 13.
    Himmelstein KJ, Patton TF, Belt RJ, et al. Clinical kinetics on intact cisplatin and some related species. Clin Pharmacol Ther 1981 May; 29(5): 658–64PubMedCrossRefGoogle Scholar
  14. 14.
    Schiller JH, Rozental J, Tutsch KD, et al. Inadvertent administration of 480 mg/m2 of cisplatin. Am J Med 1989 May; 86(5): 624–5PubMedCrossRefGoogle Scholar
  15. 15.
    Weiner MW, Jacobs C. Mechanism of cisplatin nephrotoxicity. Fed Proc 1983 Oct; 42(13): 2974–8PubMedGoogle Scholar
  16. 16.
    Bruckner HW, Wallach R, Cohen CJ, et al. High-dose platinum for the treatment of refractory ovarian cancer. Gynecol Oncol 1981 Aug; 12(1): 64–7PubMedCrossRefGoogle Scholar
  17. 17.
    Ozols RF, Corden BJ, Jacob J, et al. High-dose cisplatin in hypertonic saline. Ann Intern Med 1984 Jan; 100(1): 19–24PubMedGoogle Scholar
  18. 18.
    Ozols RF, Ostchega Y, Myers CE, et al. High-dose cisplatin in hypertonic saline in refractory ovarian cancer. J Clin Oncol 1985 Sep; 3(9): 1246–50PubMedGoogle Scholar
  19. 19.
    Rossof AH, Slayton RE, Perlia CP. Preliminary clinical experience with cis-diamminedichloroplatinum (II) (NSC 119875, CACP). Cancer 1972 Dec; 30(6): 1451–6PubMedCrossRefGoogle Scholar
  20. 20.
    Gandara DR, Mansour R, Wold H, et al. Dose-limiting myelosuppression associated with high-dose cisplatin (200 mg/m2) in hypertonic saline. Cancer Treat Rep 1986 Jun; 70(6): 820–1PubMedGoogle Scholar
  21. 21.
    van Rijswijk RE, Hoekman K, Burger CW, et al. Experience with intraperitoneal cisplatin and etoposide and i.v. sodium thiosulphate protection in ovarian cancer patients with either pathologically complete response or minimal residual disease. Ann Oncol 1997 Dec; 8(12): 1235–41PubMedCrossRefGoogle Scholar
  22. 22.
    Brivet F, Pavlovitch JM, Gouyette A, et al. Inefficiency of early prophylactic hemodialysis in cis-platinum overdose. Cancer Chemother Pharmacol 1986; 18(2): 183–4PubMedCrossRefGoogle Scholar
  23. 23.
    Chu G, Mantin R, Shen YM, et al. Massive cisplatin overdose by accidental substitution for carboplatin: toxicity and management. Cancer 1993 Dec 15; 72(12): 3707–14PubMedCrossRefGoogle Scholar
  24. 24.
    Lagrange JL, Cassuto-Viguier E, Barbé V, et al. Cytotoxic effects of long-term circulating ultrafiltrable platinum species and limited efficacy of haemodialysis in clearing them. Eur J Cancer 1994; 30(14): 2057–60CrossRefGoogle Scholar
  25. 25.
    Jung HK, Lee J, Lee SN. A case of massive cisplatin overdose managed by plasmapheresis. Korean J Intern Med 1995 Jul; 10(2): 150–4PubMedGoogle Scholar
  26. 26.
    Choi JH, Oh JC, Kim KH, et al. Successful treatment of cisplatin overdose with plasma exchange. Yonsei Med J 2002 Feb; 43(1): 128–32PubMedGoogle Scholar
  27. 27.
    Erdlenbruch B, Pekrun A, Schiffmann H, et al. Topical topic: accidental cisplatin overdose in a child: reversal of acute renal failure with sodium thiosulfate. Med Pediatr Oncol 2002 May; 38(5): 349–52PubMedCrossRefGoogle Scholar
  28. 28.
    Katz BJ, Ward JH, Digre KB, et al. Persistent severe visual and electroretinographic abnormalities after intravenous cisplatin therapy. J Neuroophthalmol 2003 Jun; 23(2): 132–5PubMedCrossRefGoogle Scholar
  29. 29.
    Hofmann G, Bauernhofer T, Krippl P, et al. Plasmapheresis reverses all side-effects of a cisplatin overdose: a case report and treatment recommendation. BMC Cancer 2006; 6: 1 [online]. Available from URL: [Accessed 2009 Oct 21]PubMedCrossRefGoogle Scholar
  30. 30.
    Haupt R, Perin G, Dallorso S, et al. Very high dose cisplatinum (450 mg/sq m) in an infant with rhabdomyosarcoma. Anticancer Res 1989 Mar–Apr; 9(2): 427–8PubMedGoogle Scholar
  31. 31.
    Vila-Torres E, Albert-Mari A, Almenar-Cubells D, et al. Case report: cisplatin preparation error; patient management and morbidity. J Oncol Pharm Pract. Epub 2009 Aug 26Google Scholar
  32. 32.
    Sheikh-Hamad D, Timmins K, Jalali Z. Cisplatin-induced renal toxicity: possible reversal by N-acetylcysteine treatment. J Am Soc Nephrol 1997 Oct; 8(10): 1640–4PubMedGoogle Scholar
  33. 33.
    Charlier C, Kintz P, Dubois N, et al. Fatal overdosage with cisplatin. J Anal Toxicol 2004 Mar; 28(2): 138–40PubMedGoogle Scholar
  34. 34.
    McKeage MJ. Comparative adverse effect profiles of platinum drugs. Drug Saf 1995 Oct; 13(4): 228–44PubMedCrossRefGoogle Scholar
  35. 35.
    Kris MG, Gralla RJ, Clark RA, et al. Incidence, course, and severity of delayed nausea and vomiting following the administration of high-dose cisplatin. J Clin Oncol 1985 Oct; 3(10): 1379–84PubMedGoogle Scholar
  36. 36.
    Fassoulaki A, Pavlou H. Overdosage intoxication with cisplatin: a cause of acute respiratory failure. J R Soc Med 1989 Nov; 82(11): 689PubMedGoogle Scholar
  37. 37.
    Skinner R. Strategies to prevent nephrotoxicity of anticancer drugs. Curr Opin Oncol 1995 Jul; 7(4): 310–5PubMedCrossRefGoogle Scholar
  38. 38.
    Dentino M, Luft FC, Yum MN, et al. Long term effect of cis-diamminedichloride platinum (CDDP) on renal function and structure in man. Cancer 1978 Apr; 41(4): 1274–81PubMedCrossRefGoogle Scholar
  39. 39.
    Gonzales-Vitale JC, Hayes DM, Cvitkovic E, et al. The renal pathology in clinical trials of cis-platinum (II) diamminedichloride. Cancer 1977 Apr; 39(4): 1362–71PubMedCrossRefGoogle Scholar
  40. 40.
    Blachley JD, Hill JB. Renal and electrolyte disturbances associated with cisplatin. Ann Intern Med 1981 Nov; 95(5): 628–32PubMedGoogle Scholar
  41. 41.
    Schilsky RL, Anderson T. Hypomagnesemia and renal magnesium wasting in patients receiving cisplatin. Ann Intern Med 1979 Jun; 90(6): 929–31PubMedGoogle Scholar
  42. 42.
    Winkler CF, Mahr MM, DeBandi H. Cisplatin and renal magnesium wasting. Ann Intern Med 1979 Sep; 91(3): 502–3PubMedGoogle Scholar
  43. 43.
    Willox JC, McAllister EJ, Sangster G, et al. Effects of magnesium supplementation in testicular cancer patients receiving cis-platin: a randomised trial. Br J Cancer 1986 Jul; 54(1): 19–23PubMedCrossRefGoogle Scholar
  44. 44.
    Lajer H, Daugaard G. Cisplatin and hypomagnesemia. Cancer Treat Rev 1999 Feb; 25(1): 47–58PubMedCrossRefGoogle Scholar
  45. 45.
    Stuart-Harris R, Ponder BA, Wrigley PF. Tetany associated with cis-platin [letter]. Lancet 1980 Dec 13; 2(8207): 1303PubMedCrossRefGoogle Scholar
  46. 46.
    Hutchison FN, Perez EA, Gandara DR, et al. Renal salt wasting in patients treated with cisplatin. Ann Intern Med 1988 Jan; 108(1): 21–5PubMedGoogle Scholar
  47. 47.
    Mariette X, Paule B, Bennet P, et al. Cisplatin and hyponatremia. Ann Intern Med 1988 May; 108(5): 770–1PubMedGoogle Scholar
  48. 48.
    Stadnicki SW, Fleischman RW, Schaeppi U, et al. Cisdichlorodiammineplatinum (II) (NSC-119875): hearing loss and other toxic effects in rhesus monkeys. Cancer Chemother Rep 1975 May–Jun; 59(3): 467–80PubMedGoogle Scholar
  49. 49.
    Kohn S, Fradis M, Pratt H, et al. Cisplatin ototoxicity in guinea pigs with special reference to toxic effects in the stria vascularis. Laryngoscope 1988 Aug; 98 (8 Pt 1): 865–71PubMedCrossRefGoogle Scholar
  50. 50.
    Marmor MF. Negative-type electroretinogram from cisplatin toxicity. Doc Ophthalmol 1993; 84(3): 237–46PubMedCrossRefGoogle Scholar
  51. 51.
    Panici PB, Greggi S, Scambia G, et al. High-dose (200 mg/m2) cisplatin-induced neurotoxicity in primary advanced ovarian cancer patients. Cancer Treat Rep 1987 Jun; 71(6): 669–70PubMedGoogle Scholar
  52. 52.
    Cohen RJ, Cuneo RA, Cruciger MP, et al. Transient left homonymous hemianopsia and encephalopathy following treatment of testicular carcinoma with cisplatinum, vinblastine, and bleomycin. J Clin Oncol 1983 Jun; 1(6): 392–3PubMedGoogle Scholar
  53. 53.
    Hitchins RN, Thomson DB. Encephalopathy following cisplatin, bleomycin and vinblastine therapy for non-seminomatous germ cell tumour of testis. Aust N Z J Med 1988 Feb; 18(1): 67–8PubMedCrossRefGoogle Scholar
  54. 54.
    Steeghs N, de Jongh FE, Sillevis Smitt PA, et al. Cisplatin-induced encephalopathy and seizures. Anticancer Drugs 2003 Jul; 14(6): 443–6PubMedCrossRefGoogle Scholar
  55. 55.
    Berman IJ, Mann MP. Seizures and transient cortical blindness associated with cis-platinum (II) diammine-dichloride (PDD) therapy in a thirty-year-old man. Cancer 1980 Feb 15; 45(4): 764–6PubMedCrossRefGoogle Scholar
  56. 56.
    Mead GM, Arnold AM, Green JA, et al. Epileptic seizures associated with cisplatin administration. Cancer Treat Rep 1982 Sep; 66(9): 1719–22PubMedGoogle Scholar
  57. 57.
    Philip PA, Carmichael J, Harris AL. Convulsions and transient cortical blindness after cisplatin [letter]. BMJ 1991 Feb 16; 302(6773): 416PubMedCrossRefGoogle Scholar
  58. 58.
    Bagley Jr CM, Rudolph RH, Rivkin SE, et al. High-dose cisplatin therapy for cancer of the ovary: neurotoxicity [letter]. Ann Intern Med 1985 May; 102(5): 719PubMedGoogle Scholar
  59. 59.
    Mollman JE. Cisplatin neurotoxicity. N Engl J Med 1990 Jan 11; 322(2): 126–7PubMedCrossRefGoogle Scholar
  60. 60.
    Lyass O, Lossos A, Hubert A, et al. Cisplatin-induced non-convulsive encephalopathy. Anticancer Drugs 1998 Jan; 9(1): 100–4PubMedCrossRefGoogle Scholar
  61. 61.
    Thompson SW, Davis LE, Kornfeld M, et al. Cisplatin neuropathy: clinical, electrophysiologic, morphologic, and toxicologic studies. Cancer 1984 Oct 1; 54(7): 1269–75PubMedCrossRefGoogle Scholar
  62. 62.
    Cavaletti G, Tredici G, Marmiroli P, et al. Morphometric study of the sensory neuron and peripheral nerve changes induced by chronic cisplatin (DDP) administration in rats. Acta Neuropathol 1992; 84(4): 364–71PubMedCrossRefGoogle Scholar
  63. 63.
    Von Hoff DD, Schilsky R, Reichert CM, et al. Toxic effects of cis-dichlorodiammineplatinum(II) in man. Cancer Treat Rep 1979 Sep–Oct; 63(9–10): 1527–31Google Scholar
  64. 64.
    Schlaeffer F, Tovi F, Leiberman A. Cisplatin-induced bradycardia. Drug Intell Clin Pharm 1983 Dec; 17(12): 899–901PubMedGoogle Scholar
  65. 65.
    Altundag O, Celik I, Kars A. Recurrent asymptomatic bradycardia episodes after cisplatin infusion. Ann Pharmacother 2001 May; 35(5): 641–2PubMedCrossRefGoogle Scholar
  66. 66.
    Hashimi LA, Khalyl MF, Salem PA. Supraventricular tachycardia: a probable complication of platinum treatment. Oncology 1984; 41(3): 174–5PubMedCrossRefGoogle Scholar
  67. 67.
    Fassio T, Canobbio L, Gasparini G, et al. Paroxysmal supraventricular tachycardia during treatment with cisplatin and etoposide combination. Oncology 1986; 43(4): 219–20PubMedCrossRefGoogle Scholar
  68. 68.
    Menard O, Martinet Y, Lamy P. Cisplatin-induced atrial fibrillation. J Clin Oncol 1991 Jan; 9(1): 192–3PubMedGoogle Scholar
  69. 69.
    Von Hoff DD, Slavik M, Muggia FM. Letter: Allergic reactions to cis platinum. Lancet 1976 Jan 10; 1(7950): 90CrossRefGoogle Scholar
  70. 70.
    ECC Committee, Subcommittees and Task Forces of the American Heart Association. 2005 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation 2005; 112 (24 Suppl): IV1–203Google Scholar
  71. 71.
    Kris MG, Hesketh PJ, Somerfield MR, et al. American Society of Clinical Oncology guideline for antiemetics in oncology: update 2006. J Clin Oncol 2006 Jun 20; 24(18): 2932–47PubMedCrossRefGoogle Scholar
  72. 72.
    Multinational Association of Supportive Care in Cancer. MASCC antiemetic guidelines, March 2008 update [online]. Available from URL: [Accessed 2009 Apr 1]
  73. 73.
    National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: antiemesis, V.3.2009 [online]. Available from URL: [Accessed 2009 Apr 1]
  74. 74.
    De Mulder PH, Seynaeve C, Vermorken JB, et al. Ondansetron compared with high-dose metoclopramide in prophylaxis of acute and delayed cisplatin-induced nausea and vomiting: a multicenter, randomized, double-blind, crossover study. Ann Intern Med 1990 Dec 1; 113(11): 834–40PubMedGoogle Scholar
  75. 75.
    Marty M, Pouillart P, Scholl S, et al. Comparison of the 5-hydroxytryptamine3 (serotonin) antagonist ondansetron (GR 38032F) with high-dose metoclopramide in the control of cisplatin-induced emesis. N Engl J Med 1990 Mar 22; 322(12): 816–21PubMedCrossRefGoogle Scholar
  76. 76.
    Hainsworth J, Harvey W, Pendergrass K, et al. A single-blind comparison of intravenous ondansetron, a selective serotonin antagonist, with intravenous metoclopramide in the prevention of nausea and vomiting associated with high-dose cisplatin chemotherapy. J Clin Oncol 1991 May; 9(5): 721–8PubMedGoogle Scholar
  77. 77.
    Smith DB, Newlands ES, Rustin GJ, et al. Comparison of ondansetron and ondansetron plus dexamethasone as antiemetic prophylaxis during cisplatin-containing chemotherapy. Lancet 1991 Aug 24; 338(8765): 487–90PubMedCrossRefGoogle Scholar
  78. 78.
    Al-Sarraf M, Fletcher W, Oishi N, et al. Cisplatin hydration with and without mannitol diuresis in refractory disseminated malignant melanoma: a southwest oncology group study. Cancer Treat Rep 1982 Jan; 66(1): 31–5PubMedGoogle Scholar
  79. 79.
    Legha SS, Dimery IW. High-dose cisplatin administration without hypertonic saline: observation of disabling neurotoxicity. J Clin Oncol 1985 Oct; 3(10): 1373–8PubMedGoogle Scholar
  80. 80.
    Vogl SE, Zaravinos T, Kaplan BH. Toxicity of cisdiamminedichloroplatinum II given in a two-hour out-patient regimen of diuresis and hydration. Cancer 1980 Jan 1; 45(1): 11–5PubMedCrossRefGoogle Scholar
  81. 81.
    Pfeifle CE, Howell SB, Felthouse RD, et al. High-dose cisplatin with sodium thiosulfate protection. J Clin Oncol 1985 Feb; 3(2): 237–44PubMedGoogle Scholar
  82. 82.
    Hirosawa A, Niitani H, Hayashibara K, et al. Effects of sodium thiosulfate in combination therapy of cisdichlorodiammineplatinum and vindesine. Cancer Chemother Pharmacol 1989; 23(4): 255–8PubMedCrossRefGoogle Scholar
  83. 83.
    Markman M, D’Acquisto R, Iannotti N, et al. Phase-1 trial of high-dose intravenous cisplatin with simultaneous intravenous sodium thiosulfate. J Cancer Res Clin Oncol 1991; 117(2): 151–5PubMedCrossRefGoogle Scholar
  84. 84.
    Howell SB, Pfeifle CL, Wung WE, et al. Intraperitoneal cisplatin with systemic thiosulfate protection. Ann Intern Med 1982 Dec; 97(6): 845–51PubMedGoogle Scholar
  85. 85.
    Markman M, Cleary S, Howell SB. Nephrotoxicity of high-dose intracavitary cisplatin with intravenous thiosulfate protection. Eur J Cancer Clin Oncol 1985 Sep; 21(9): 1015–8PubMedCrossRefGoogle Scholar
  86. 86.
    Markman M, Cleary S, Pfeifle CE, et al. High-dose intracavitary cisplatin with intravenous thiosulfate: low incidence of serious neurotoxicity. Cancer 1985 Nov 15; 56(10): 2364–8PubMedCrossRefGoogle Scholar
  87. 87.
    Nagai N, Hotta K, Yamamura H, et al. Effects of sodium thiosulfate on the pharmacokinetics of unchanged cisplatin and on the distribution of platinum species in rat kidney: protective mechanism against cisplatin nephrotoxicity. Cancer Chemother Pharmacol 1995; 36(5): 404–10PubMedCrossRefGoogle Scholar
  88. 88.
    Markman M, Cleary S, Howell SB. Hypomagnesemia following high-dose intracavitary cisplatin with systemically administered sodium thiosulfate. Am J Clin Oncol 1986 Oct; 9(5): 440–3PubMedCrossRefGoogle Scholar
  89. 89.
    Fojo A. Metabolic emergencies: hyperuricemia. In: Devita V, Lawrence T, Rosenberg S, editors. Devita, Hellman & Rosenberg’s cancer: principles & practice of oncology. 8th ed. Philadelphia (PA): Lippincott Williams & Wilkins, 2008: 2447–9Google Scholar
  90. 90.
    Coiffier B, Altman A, Pui CH, et al. Guidelines for the management of pediatric and adult tumor lysis syndrome: an evidence-based review. J Clin Oncol 2008 Jun 1; 26(16): 2767–78PubMedCrossRefGoogle Scholar
  91. 91.
    Schiffer CA, Anderson KC, Bennett CL, et al. Platelet transfusion for patients with cancer: clinical practice guidelines of the American Society of Clinical Oncology. J Clin Oncol 2001 Mar 1; 19(5): 1519–38PubMedGoogle Scholar
  92. 92.
    Rizzo JD, Somerfield MR, Hagerty KL, et al. Use of epoetin and darbepoetin in patients with cancer: 2007 American Society of Hematology/American Society of Clinical Oncology clinical practice guideline update. Blood 2008 Jan 1; 111(1): 25–41PubMedCrossRefGoogle Scholar
  93. 93.
    National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: cancer- and chemotherapy-induced anemia, V.3.2009 [online]. Available from URL: [Accessed 2009 Apr 1]
  94. 94.
    National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: prevention and treatment of cancer-related infections, V. 1.2008 [online]. Available from URL: [Accessed 2009 Apr 1]
  95. 95.
    Smith TJ, Khatcheressian J, Lyman GH, et al. 2006 update of recommendations for the use of white blood cell growth factors: an evidence-based clinical practice guideline. J Clin Oncol 2006 Jul 1; 24(19): 3187–205PubMedCrossRefGoogle Scholar
  96. 96.
    National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: myeloid growth factors, V.1.2009 [online]. Available from URL: [Accessed 2009 Apr 1]
  97. 97.
    Hartmann LC, Tschetter LK, Habermann TM, et al. Granulocyte colony-stimulating factor in severe chemotherapy-induced afebrile neutropenia. N Engl J Med 1997 Jun 19; 336(25): 1776–80PubMedCrossRefGoogle Scholar
  98. 98.
    Albers J, Chaudhry V, Cavaletti G, et al. Interventions for preventing neuropathy caused by cisplatin and related compounds. Cochrane Database Syst Rev 2007; (1): CD005228Google Scholar
  99. 99.
    Fisher MJ, Lange BJ, Needle MN, et al. Amifostine for children with medulloblastoma treated with cisplatin-based chemotherapy. Pediatr Blood Cancer 2004 Dec; 43(7): 780–4PubMedCrossRefGoogle Scholar
  100. 100.
    Sastry J, Kellie SJ. Severe neurotoxicity, ototoxicity and nephrotoxicity following high-dose cisplatin and amifostine. Pediatr Hematol Oncol 2005 Jul–Aug; 22(5): 441–5PubMedCrossRefGoogle Scholar
  101. 101.
    Ekborn A, Hansson J, Ehrsson H, et al. High-dose cisplatin with amifostine: ototoxicity and pharmacokinetics. Laryngoscope 2004 Sep; 114(9): 1660–7PubMedCrossRefGoogle Scholar
  102. 102.
    Qazi R, Chang AY, Borch RF, et al. Phase I clinical and pharmacokinetic study of diethyldithiocarbamate as a chemoprotector from toxic effects of cisplatin. J Natl Cancer Inst 1988 Nov 16; 80(18): 1486–8PubMedCrossRefGoogle Scholar
  103. 103.
    DeGregorio MW, Gandara DR, Holleran WM, et al. High-dose cisplatin with diethyldithiocarbamate (DDTC) rescue therapy: preliminary pharmacologic observations. Cancer Chemother Pharmacol 1989; 23(5): 276–8PubMedCrossRefGoogle Scholar
  104. 104.
    Nisar S, Feinfeld DA. N-acetylcysteine as salvage therapy in cisplatin nephrotoxicity. Ren Fail 2002 Jul; 24(4): 529–33PubMedCrossRefGoogle Scholar
  105. 105.
    Schweitzer VG, Dolan DF, Abrams GE, et al. Amelioration of cisplatin-induced ototoxicity by fosfomycin. Laryngoscope 1986 Sep; 96 (9 Pt 1): 948–58PubMedGoogle Scholar
  106. 106.
    Umeki S, Watanabe M, Yagi S, et al. Supplemental fosfomycin and/or steroids that reduce cisplatin-induced nephrotoxicity. Am J Med Sci 1988 Jan; 295(1): 6–10PubMedCrossRefGoogle Scholar
  107. 107.
    Gandhi TK, Bartel SB, Shulman LN, et al. Medication safety in the ambulatory chemotherapy setting. Cancer 2005 Dec 1; 104(11): 2477–83PubMedCrossRefGoogle Scholar
  108. 108.
    Muller T. Typical medication errors in oncology: analysis and prevention strategies. Onkologie 2003 Dec; 26(6): 539–44PubMedCrossRefGoogle Scholar
  109. 109.
    Huertas Fernandez MJ, Baena-Canada JM, Martinez Bautista MJ, et al. Impact of computerised chemotherapy prescriptions on the prevention of medication errors. Clin Transl Oncol 2006 Nov; 8(11): 821–5PubMedCrossRefGoogle Scholar
  110. 110.
    Schulmeister L. Preventing chemotherapy errors. Oncologist 2006 May; 11(5): 463–8PubMedCrossRefGoogle Scholar
  111. 111.
    Voeffray M, Pannatier A, Stupp R, et al. Effect of computerisation on the quality and safety of chemotherapy prescription. Qual Saf Health Care 2006 Dec; 15(6): 418–21PubMedCrossRefGoogle Scholar

Copyright information

© Adis Data Information BV 2009

Authors and Affiliations

  • Roger Y. Tsang
    • 1
  • Turki Al-Fayea
    • 1
  • Heather-Jane Au
    • 1
    Email author
  1. 1.Department of Oncology, Division of Medical OncologyCross Cancer Instituteand University of AlbertaEdmontonCanada

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