Uroprotective Efficacy and Safety of Mesna for Oxazaphosphorines in Pediatric Patients

Abstract

To evaluate the uroprotective efficacy and safety of mesna in pediatric patients, a prospective investigation was performed. 135 patients who received oxazaphosphorines and mesna at high-dose chemotherapy (ifomide (IFO); total 161 courses, cyclophosphamide (CPM); total 165 courses) and 73 patients conditioned by oxazaphosphorines with mesna at bone marrow transplantation (BMT) were analyzed. The incidence of [a] total hematuria (gross hematuria) and [b] irritative voiding symptoms at chemotherapy in IFO-treated patients were [a] 8.7% (2.5%), [b.] 5.0%, respectively, and those in CPM-treated patients were [a] 4.2% (0%), [b] 0.6%, respectively. At BMT, these incidences were higher with ([a] 29.2% (16.7%) and [b] 18.1%). No allergic symptoms or adverse effects caused by mesna were observed. We conclude that mesna is effective without any side effects in pediatric patients for the uroprotection at oxazaphosphorine chemotherapy ; however, at BMT, further supportive care and refinement of mesna administration are required.