Cisplatin

Acute cisplatin-related nephrotoxicity has been reported in 30% to 100% of exposed children.[14] However, the prevalence of persistent renal dysfunction in long-term survivors appears to be considerably lower.

The DCCSS-LATER 2 kidney analysis, a nationwide cross-sectional cohort study, evaluated 1,024 survivors (aged 18 years or older at the time of the study) for long-term tubular dysfunction. These patients were 5 or more years from diagnosis and treated between 1963 and 2001 with nephrectomy, abdominal radiation therapy, TBI, cisplatin, carboplatin, ifosfamide, high-dose cyclophosphamide, or HSCT. Survivors were compared with 500 age- and sex-matched controls.[6]

The DCCSS-LATER 2 kidney analysis, a nationwide cross-sectional cohort study, evaluated 1,024 survivors (aged 18 years or older at the time of the study) for long-term tubular dysfunction. These patients were 5 or more years from diagnosis and treated between 1963 and 2001 with nephrectomy, abdominal radiation therapy, TBI, cisplatin, carboplatin, ifosfamide, high-dose cyclophosphamide, or HSCT. Survivors were compared with 500 age- and sex-matched controls.[6]

In general, prevalence and ORs for magnesium loss were significantly increased for childhood cancer survivors treated with cisplatin only (25.8%) or in combination with carboplatin (23.1%).

The DCCSS-LATER 2 kidney analysis, a nationwide cross-sectional cohort study, evaluated 1,024 survivors (aged 18 years or older at the time of the study) for long-term tubular dysfunction. These patients were 5 or more years from diagnosis and treated between 1963 and 2001 with nephrectomy, abdominal radiation therapy, TBI, cisplatin, carboplatin, ifosfamide, high-dose cyclophosphamide, or HSCT. Survivors were compared with 500 age- and sex-matched controls.[6]

Magnesium loss was associated with all doses of cisplatin but highest for a cumulative dose greater than 500 mg/m2 (OR, 22.0). Childhood cancer survivors exposed only to cisplatin were at risk for potassium loss in comparison with controls (prevalence, 12%; OR, 3.2).

The DCCSS-LATER 2 kidney analysis, a nationwide cross-sectional cohort study, evaluated 1,024 survivors (aged 18 years or older at the time of the study) for long-term tubular dysfunction. These patients were 5 or more years from diagnosis and treated between 1963 and 2001 with nephrectomy, abdominal radiation therapy, TBI, cisplatin, carboplatin, ifosfamide, high-dose cyclophosphamide, or HSCT. Survivors were compared with 500 age- and sex-matched controls.[6]

At cumulative doses of cisplatin of higher than 500 mg/m2, the odds for potassium (OR, 17.7) and phosphate loss (OR, 3.6) were increased.

Among 63 children treated with platinum agents, GFR was less than 60 mL/min per 1.73 m2 in 11% of children, and hypomagnesemia requiring oral supplements occurred in 7% of children at 10 years from completion of therapy.[15]