Cisplatin-induced nephrotoxicity in children: what is the best protective strategy?. (January 2021)

• Record Type: Journal Article
• Authors: Ruggiero, Antonio; Ariano, Anna; Triarico, Silvia; Capozza, Michele Antonio; Romano, Alberto; Maurizi, Palma; Mastrangelo, Stefano; Attinà, Giorgio
• Is Part Of: Journal of oncology pharmacy practice. Volume 27:Number 1(2021)
• Page Start: 180
• Page End: 186
• Publication Date: 2021-01
• Subjects: Cisplatin -- nephrotoxicity -- hydration -- mannitol -- children; Cancer -- Chemotherapy -- Periodicals; Clinical pharmacology -- Periodicals; 616.994061
• DOI: 10.1177/1078155220961550
• Languages: English
• ISSNs: 1078-1552

Abstract

Introduction: Platinum compounds, which are considerably effective for the treatment of childhood malignancies, have significantly contributed to the increase in long-term survival of children with cancer. Unfortunately, children receiving cisplatin-based chemotherapy have been known to be at risk for severe disabling adverse effects, such as nephrotoxicity. Methods: A literature research of the MEDLINE PubMed database was conducted to identify articles published between 1980 and 2019 reviewing "Cisplatin AND mannitol." Results: The primary pharmacodynamics and clinical characteristics of cisplatin were described, focusing on its renal toxic effects and potential preventive strategies, in order to improve clinical outcomes among children with cancer aged 1 to 14 years. Currently, selecting either hydration alone or hydration plus mannitol for preventing nephrotoxicity has been controversial considering the lack of guidelines to provide treatment recommendations both among adults and children. Conclusions: Appropriate knowledge regarding the pharmacokinetics and toxicological profile of cisplatin may help physicians prevent renal toxicity. Unfortunately, published data regarding the nephroprotective utility of adding mannitol appear to be inconclusive. As such, appropriate hydration remains the main fundamental strategy for reducing the risk of cisplatin-induced nephrotoxicity. Considering the increasing number of children safely cured of their tumours, it is imperative that those treated with cisplatin receive the most appropriate nephroprotective strategy for reducing the negative impact of platinum compounds on quality of life.