A case of Ifosfamide-induced dysuria which could be avoided by changing the regimen of mesna

• Published in: Gan to kagaku ryoho Vol. 40; no. 3; p. 413
• Main Authors: Yamamoto, Yoshihiro, Tsukiyama, Ikuto, Nii, Shota, Harada, Ryusuke, Watanabe, Kazushi, Yabushita, Hiromitsu, Wakatsuki, Akihiko, Saito, Hiroko, Hasegawa, Takaaki
• Format: Journal Article
• Language: Japanese
• Published: Japan 01-03-2013
• Subjects: Adult; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Cisplatin - administration & dosage; Dysuria - chemically induced; Dysuria - prevention & control; Female; Humans; Ifosfamide - administration & dosage; Ifosfamide - adverse effects; Lung Neoplasms - drug therapy; Lung Neoplasms - secondary; Lymphatic Metastasis; Recurrence; Uterine Cervical Neoplasms - drug therapy; Uterine Cervical Neoplasms - pathology
• ISSN: 0385-0684

A 39-year-old woman with advanced and recurrent cervical carcinoma received chemotherapy with IFM+CDDP(IFM 5, 000mg/m2 by intravenous infusion for 24 hours and CDDP 50 mg/m2 by intravenous infusion for one hour)in September of 2011. Mesna(3, 200mg/body)was administered intravenously for 30min three times a day to prevent IFM-induced hemorrhagic cystitis. She complained of residual urine from the evening of day 2 and felt pain during urination from day 3 (urinary tract pain: Grade 1 CTCAE v4.0 ). Both symptoms continued until day 6. When the infusion rate of mesna was changed to 24 hours of continuous administration, as with IFM on the second course, no symptoms which occurred during the first course were observed. The chemotherapy could be continued without compromising her QOL. The present finding suggests that IFM-induced dysuria could be avoided by changing the regimen to mesna, due to the increase in its binding potency and the metabolite of IFM, acrolein.