Prolonged 14-day continuous infusion of high-dose ifosfamide with an external portable pump: feasibility and efficacy in refractory pediatric sarcoma

Pediatr Blood Cancer. 2010 Oct;55(4):617-20. doi: 10.1002/pbc.22596.

Abstract

Background: Ifosfamide is currently used to treat pediatric sarcomas and increasing its dosage may be associated with a better response rate. Prolonged continuous infusion seems an attractive administration modality.

Methods: Ifosfamide 14 g/m(2) (with mesna 14 g/m(2)) was administered through an ambulatory portable pump over 14 days as a continuous infusion, starting every 3 weeks, in 14 patients with relapsing sarcomas. No growth factors were given.

Results: Acute grade 3 hematological toxicity was observed in only 13/66 cycles and red cell transfusions were given in two patients. Hematuria and dysuria occurred in three cases. The response rate was: five partial responses, five stable disease. The median time to progression was 3 months (range: 2-19 months). The best response rate was seen for synovial sarcoma and Ewing sarcoma.

Conclusion: Prolonged 14-day continuous infusion of high-dose ifosfamide is well tolerated. Potentially interesting preliminary responses in pediatric patients already treated with ifosfamide are reported.

MeSH terms

  • Adolescent
  • Antineoplastic Agents, Alkylating / administration & dosage*
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Ifosfamide / administration & dosage*
  • Ifosfamide / adverse effects
  • Infant
  • Infusion Pumps
  • Male
  • Sarcoma / drug therapy*

Substances

  • Antineoplastic Agents, Alkylating
  • Ifosfamide