Summary
Ifosfamide (IFS) is a new alkylating oxazaphosphorine related to cyclophosphamide. Various side effects have been reported; however, cardiotoxicity is not known to occur in humans. We report for first time acute cardiac side effects upon IFS treatment in the form of supraventricular arrhythmias and ST-T wave changes. IFS dose ranged from 6.5 g/m2 to 10 g/m2 fractionated in 3 or 5 days and infused i.v. over 4 h daily together with 2-mercaptoethane sulphonate sodium (Mesna). Arrhythmias appeared to be reversible upon discontinuation of the drug. In one patient, readministration of IFS led to arrhythmia that was refractory to treatment. Factors predisposing to the development of cardiac side effects could not be determined in this study. We suggest that patients who receive IFS treatment should be monitored for the occurrence of cardiac abnormalities. Readministration of the drug may be contraindicated in such patients.
References
Brade WP, Hedrich K, Varini M, (1985) Ifosfamide-pharmacology, safety and therapeutic potential. Cancer Treat Rev 12: 1
Bremer DN, McGormic JS, Thomson JWW (1974) Clinical trial of isophosphamide (NSC 109724). Results and side effects. Cancer Chemother Rep 58: 889
Bryant BM, Jarmant M, Ford HT, Smith IE (1980) Prevention of isophosphamide-induced urothelial toxicity with 2-mercaptoethane sulphonate sodium (mesna) in patients with advanced carcinoma. Lancet II: 657
Goldin A, Venditti JM, Kline I, Wodinski I, Little AD, Schabel FM (1977) Preclinical investigations with ifosfamide in relation to cyclophosphamide. Proceedings, International Holoxan-Symposium, Düsseldorf Asta Werke, Bielefeld, p 19
Van Oosterau AT, Einhorn LH, Brade W (1986) Recent experience with Ifosfamide/Mesna in solid tumors. Cancer Chemother Pharmacol 18 [Suppl 2]: 1–58
Herman EM, Mhatre RM, Warardekar VS Lee IP (1972) Comparison of the cardiovascular actions of NSC-109, 724 (ifosfamide) and cyclophosphamide. Toxicol Appl Pharmacol 23: 178
Kehl A, Von Heyden HD, Nagel GA (1982) Toxic allergic pulmonary edema after therapy with cyclophosphamide/ifosfamide. Blut 45: 210
O'Connel TX, Berenbaum MC (1974) Cardiac and pulmonary effects of high doses of cyclophosphamide and isophosphamide. Cancer Res 34: 1586
Cancer Chemother Pharmacol 18 [Suppl 2] Recent experience with ifosfamide/mesna in solid tumours (ed. by Osteron AT van, Einhorn LH, Brade W)
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Kandylis, K., Vassilomanolakis, M., Tsoussis, S. et al. Ifosfamide cardiotoxicity in humans. Cancer Chemother. Pharmacol. 24, 395–396 (1989). https://doi.org/10.1007/BF00257451
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DOI: https://doi.org/10.1007/BF00257451