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Related Experiment Videos

Fractionated high-dose cyclophosphamide for advanced pediatric solid tumors

L L Chan1, J Ater, A Cangir

  • 1Department of Pediatrics, University of Texas M.D. Anderson Cancer Center, Houston 77030, USA.

Journal of Pediatric Hematology/Oncology
|February 1, 1996
PubMed
Summary
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High-dose cyclophosphamide (CPA) at 7 g/m2 is well tolerated in children with advanced solid tumors. This regimen showed manageable toxicities and should be considered for earlier cancer treatment.

Area of Science:

  • Pediatric Oncology
  • Pharmacology
  • Cancer Treatment

Background:

  • Advanced solid tumors in children pose significant treatment challenges.
  • High-dose chemotherapy regimens are often explored to improve outcomes.
  • Cyclophosphamide (CPA) is a widely used chemotherapeutic agent.

Purpose of the Study:

  • To evaluate the safety and tolerability of high-dose cyclophosphamide (CPA) at 7 g/m2 in pediatric patients.
  • To assess the toxicities associated with a specific dosing schedule of CPA (four fractions over 8 hours).
  • To determine the feasibility of outpatient management for this high-dose CPA regimen.

Main Methods:

  • Twenty pediatric patients with advanced solid tumors received 24 courses of CPA at 7 g/m2.
  • CPA was administered in four divided infusions over 8 hours, with MESNA for uroprotection.

Related Experiment Videos

  • Supportive care included G-CSF, ciprofloxacin, and co-trimoxazole; most patients were managed as outpatients.

    • Main Results:

    • Severe but transient myelosuppression was observed, with median recovery times of 17 days for neutrophils and 19 days for platelets.
    • Fever occurred in 13 courses, necessitating hospitalization in some cases.
    • No instances of cardiomyopathy or hemorrhagic cystitis were reported, and 46% of courses were managed outpatient.

    Conclusions:

    • High-dose cyclophosphamide (CPA) at 7 g/m2 is well-tolerated in pediatric patients with advanced malignancies.
    • The regimen is associated with manageable toxicities, including mild extramedullary effects.
    • This CPA dosing strategy warrants consideration for earlier phases of antineoplastic therapy in children.