Thiotepa-induced myelosuppression: review of 670 bladder instillations

Intravesical chemotherapy is an integral part of the therapeutic strategy for patients with superficial bladder cancer. Despite the introduction of new agents thiotepa currently is used most owing to its low cost and moderate effectiveness. Myelosuppression is a side effect caused by absorption of the drug through the bladder mucosa. A review of 670 instillations of thiotepa in 72 patients at our medical center revealed a decrease in the white blood or platelet count below normal in 18 per cent of the patients (3.9 per cent of the instillations). In no case did this decrease lead to any problem other than a delay in therapy.