Observation and prevention of toxicity of super high dose of cyclophosphamide chemotherapy scheme for treating children with high risk neuroblastoma / 中华实用儿科临床杂志

ABSTRACT

Objective To observe a variety of the toxicity,and the incidence of super-high-dose cyclophosphamide as a main chemotherapy scheme for treating children with high risk neuroblastoma,and to summarize the prevention and cure of the disease.Methods The high risk neuroblastoma patients who were diagnosed in Hematologic Tumor of Beijing Children's Hospital Affiliated to Capital Medical University were selected.And they were received super high dose of cyclophosphamide mainly chemotherapy scheme-CAV (cyclophosphamide,adriamycin and vincristine) more than 2 courses according to BCH-NB-HR(Beijing Children's Hospital-Neuroblastoma-High Risk) scheme.Their clinical symptoms,signs,blood routine and blood biochemistry in 1-2-course of treatment were retrospectively analyzed and summarized.According to WHO anti-cancer drugs in acute and subacute toxicity reaction grading standards,the data were analyzed.Results There were 33 children consistent with the criterion of research,who received 66 times of super-high-dose cyclophosphamide as a main chemotherapy scheme.All of the patients had bone marrow suppression,granulocyte generated Ⅳ grade toxicity 56 (84.8％),white blood cell (＜ 1.0 × 109/L) Ⅳ grade toxicity was 56 (84.8％),and blood platelet(＜25 x 109/L) Ⅳ grade toxicity was 19(28.8％).Hemoglobin(＜65 g/L) Ⅳ grade toxicity was 4 (6.06％).The digestive system toxicity including nausea and vomiting toxicity (100.0％).Urogenital system toxicityHemorrhagic cystitis only was 1 (1.52％) ;Cardiac Ⅰ-Ⅲ grade toxicity was 3(4.55％).But skin and nervous system toxicity was not observed.No patients died from chemotherapy.Conclusions There is a high incidence of toxicity with super-high-dose of cyclophosphamide as a main chemotherapy scheme,and the highest incidence ineludes bone marrow suppression,digestive tract response and secondary infection.But side effects like hemorrhagic cys-titis,liver,kidney and cardiac toxicity are not significant.Super-high-dose cyclophosphamide chemotherapy scheme is clinically safe under the perfect supportive treatment and rigorous monitoring.