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Original Research

Background: The incidence of tumor lysis syndrome (TLS) has been reported in 42% of adults with hematologic malignancies and can result in serious laboratory findings and clinical manifestations. The clinical manifestations may be severe, leading to dialysis therapy and/or death. The exact incidence of these severe outcomes has not been determined; however, strategies to determine the risk for these complications have been proposed.

Carboplatin is a platinum chemotherapeutic agent introduced in 1981 as an alternative to cisplatin.

Background: Ifosfamide is a frequently used nitrogen mustard chemotherapeutic alkylating agent that is available commercially in either an aqueous or powder formulation. Documented toxicities related to ifosfamide include a unique neurotoxicity that has been associated with hypoalbuminemia, previous or concurrent administration of other neurotoxic agents, and renal dysfunction. Although data regarding ifosfamide neurotoxicity are available in adult medical oncology literature, studies regarding pediatric neurotoxicity are limited.

Background: Serum creatinine–based formulas are used to estimate glomerular filtration rate when calculating carboplatin dosage with the Calvert formula. In overweight and obese patients, body weight applied to serum creatinine–based formulas may overestimate glomerular filtration rate. Overestimation may result in divergent carboplatin dosages that correlate with dose-limiting thrombocytopenia, treatment delays, and dose reductions.

Background: Ifosfamide-based chemotherapy is the standard of care for treatment of softtissue sarcomas. Previous studies have shown an increased risk for ifosfamide neurotoxicity among patients with low albumin levels, but the association between aprepitant use and the risk of neurotoxicity in patients receiving ifosfamide-based chemotherapy is still unknown and controversial.

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