Cisplatin therapy in infants: short and long-term morbidity

The tolerance to and toxicity of cisplatin treatment was retrospectively studied in 30 infants. A total of 191 courses were given with a median of six per child and a median cumulative dose of 400 mg m-2. Electrolyte disturbances were noted in 15/23 infants (38:144 courses): hypomagnesaemia, which was dose related, in 10/23 (25/144 courses), hyponatraemia in 6/23 (7:144 courses), hypercalcaemia in 4/23 (6/144 courses), and hypocalcaemia in 3/23 (4/144 courses). Seizures occurred in two infants. Vomiting followed 31/191 courses and neutropenic febrile episodes 23/191 courses. Median survival is 6 years 1 month. Six children have died of progressive malignancy. Glomerular filtration rate was less than 80 ml min-1 per 1.73 m2 in 15/29 children, at or within a month of the end of treatment; of ten retested at follow-up, eight had increased to more than 80 ml min-1 per 1.73 m2 (P = 0.027). High-frequency hearing loss was observed in 10/28 children, but was only significant in five (four grade 2 and one grade 3).

the long-term toxicity of cisplatin in infants, at this dose range and schedule, is no more severe than in older children.