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The Protective Effect of 2-Mercapto-Ethane Sulfonate (MESNA) on Hemorrhagic Cystitis Induced by High-Dose Ifosfamide Treatment Tested by a Randomized Crossover Trial |
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| Authors: | SAKURAI, MASANORI SAIJO, NAGAHIRO SHINKAI, TETSU EGUCHI, KENJI SASAKI, YASUTSUNA TAMURA, TOMOHIDE SANO, TETSURO SUEMASU, KEIICHI JETT, JAMES R. |
| Affiliation: | Department of Internal Medicine, National Cancer Center Hospital Tokyo 1Department of Thoracic Surgery, National Cancer Center Hospital Tokyo 2Mayo Clinic Rochester Minn., USA |
| Abstract: | High-dose ifosfamide (one or two courses of 6 g/m2) with orwithout mesna was administered to 13 patients with advancednon-small cell lung cancer. The protective effect of 2-mercapto-ethanesulfonate (mesna) against the urotoxic side effects inducedby ifosfamide was examined by a randomized crossover trial.A significant reduction in the incidence of hematuria was observedin the patients receiving mesna. Macroscopic hematuria was observedin only one patient who received treatment with mesna versusseven patients treated with ifosfamide alone. Other symptoms,such as frequency and dysuria, tended to be diminished in thepatients receiving mesna, although the difference was not statisticallysignificant. Our results suggest that mesna is effective inpreventing or diminishing ifosfamide-induced hemorrhagic cystitis.Concomitant use of mesna should allow the administration ofa high dose of ifosfamide although more extensive studies areneeded to define the optimal dose and schedule of administrationof mesna to prevent or attenuate the hemorrhagic cystitis. |
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