Ifosfamide-related encephalopathy in elderly patients : report of five cases and review of the literature.

摘要: Encephalopathy is a serious adverse reaction occurring in 15–30% of patients treated with the alkylating agent ifosfamide. Patients this effect may experience seizures, drowsiness, confusion and hallucinations different grades severity. In article, we describe five cases acute CNS toxicity aged ≥65 years age ifosfamide review data on management outcome complication elderly patients. All experienced symptoms encephalopathy soon after receiving combination chemotherapy including for tumours. had been assessed by means Comprehensive Geriatric Assessment presence associated diseases, disability, cognitive status depression, scores were satisfactory all patients, although case 5 was deemed frail because cancer-related limitation movement. four antidote methylene blue (methylthioninium chloride) administered intravenously, successful recovery three fatal fourth patient. The fifth patient rapidly recovered discontinuation did not receive blue. roles older age, peak concentration, low albumin levels, increased serum creatinine bulky abdominal disease as predisposing factors ifosfamide-related retrospective series are controversial. Although has frequently encephalopathy, its efficacy context objectively. Thus, careful baseline evaluation constant clinical observation during infusion, especially first course therapy, recommended to reduce risk severe from