REMOVAL OF EXCESS CISPLATIN FROM BLOOD USING AN EXTRACORPOREAL DEVICE WITH IMMOBILIZED ADSORBENT

• Published in: ASAIO journal (1992) Vol. 46; no. 2; p. 228
• Main Authors: Ambrus, C M, Karakousis, C, Khan, S, Stadler, A
• Format: Journal Article
• Language: English
• Published: 01-04-2000
• Subjects: Adsorbents; Biomedical equipment; Blood; Blood vessels; Dialysis; Toxicity
• ISSN: 1058-2916
• DOI: 10.1097/00002480-200003000-00308

Cisplatin is presently among the most frequently used chemotherapeutic agents for the treatment of malignant tumors, however the side affects that accompany cisplatin infusion restrict the dose that can be safely applied. Toxicity can be reduced by removing cisplatin leaving the tumor before it is distributed in the general circulation. This can be accomplished using a hollow fiber device developed for extracorporeal removal of cisplatin from blood. The devices employed are converted dialysis cartridges with 10,000 hollow fibers, where cisplatin adsorbent is immobilized behind the fiber membrane. As blood flows through the fibers, circulating cisplatin crosses the pores, and is retained by the adsorbent. A broad range of materials, polymeric adsorbent resins in colloidal form, lipophilic and hydrophilic dextrans were tested for their cisplatin binding capacity and kinetics, at clinically relevant concentrations of cisplatin. Charcoal showed the highest adsorbent capacity: 1044 ug cisplatin per g. Devices prepared with charcoal were tested in in vitro experiments for the ability to remove cisplatin from aqueous solutions and from cisplatin spiked serum. When blood obtained from patients during cisplatin infusion was circulated through the device, 80% of cisplatin was removed. In dog experiments, cisplatin (100 mg/m2) infused into the femoral artery was captured by the device inserted into the femoral vein. Thus restriction of the cisplatin to the area to be treated allows for higher local doses and reduces systemic side effects. Clinical studies with localized cisplatin infusions are being planned.