The aim of this short communication is to discuss the mechanism, modality and treatment of ifosfamide encephalopathy. We present the case of a 52-year-old woman treated with this alkylating agent who developed severe neurotoxicity. It was resolved with administration of Methylene blue, abundant intravenous hydration and interruption of ifosfamide.
KerbuschT., de KrakerJ., KeizerH.J., Van PuttenJ.W., GroenH.J.M., JansenR.L., SchellensJ.H., BeijnenJ.H.: Clinical pharmacokinetics and pharmacodynamics of ifosfamide and its metabolites.Clin Pharmacokinet, 40: 41–62, 2001.
2.
AeschlimannC., KupferA., ScheferH., CernyT.: Comparative pharmacokinetics of oral and intravenous ifosfamide/mes-na/methylene blue therapy.Drug Met Dispos, 26: 883–890, 1998.
3.
ComandoneA., LeoneL., OlivaC., FrustaciS., MonteleoneM., ColussiA.M., Dal CantonO., BergnoloP., BuglioneA., BummaC.: Pharmacokinetics of ifosfamide administered according to three different schedules in metastatic soft tissue and bone sarcoma.J Chemother, 10: 385–393, 1998.
4.
KupferA., AeschlimannC., CernyT.: Methylene blue and the neurotoxic mechanism of ifosfamide encephalopathy.Eur J Clin Pharmacol, 50: 249–252, 1996.
5.
HighleyM.S., MomerencyG., Van CauwenbergheK., Van Oos-teromA.T., de BruijnE.A., MaesR.A., BlakeP., MansiJ., HarperP.G.: Formation of chloroethylamine and 1,3-oxazolidine-2-one following ifosfamide administration in humans.Drug Metab Dispos, 23: 433–437, 1995.