Severe post-treatment leukopenia associated with the development of encephalopathy following ifosfamide infusion

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Ifosfamide has been shown to be associated with encephalopathy in 10-40% of patients. Although it is a welldocumented toxicity associated with ifosfamide therapy, an anecdotal upsurge in its occurrence at our institution prompted us to review ifosfamide usage. A 1-year singlecenter retrospective study was performed to assess the incidence of and potential risk factors for ifosfamideinduced encephalopathy (IIE). A total of 28 inpatients received ifosfamide-based chemotherapy over 47 separate treatment sessions. During those treatment sessions, seven cases of IIE (14.9%) were observed, which presented a significant increase compared with historical data from our institution (≤3.3%). On the basis of these data, we switched from the ifosfamide product made from Sicor's liquid formulation for injection to that made from a different manufacturer's powder formulation for injection in 2010. Since this switch in the ifosfamide formulation was made, we have observed a reduction in the rate and severity of IIE at our institution. It is noteworthy that the infusions associated with encephalopathy showed a significantly higher degree of post-treatment leukopenia compared with those that did not. In the absence of chromatography analysis and/or potency analysis, we could not definitely attribute the high rate of IIE observed in our study to the liquid ifosfamide formulation; nevertheless, practitioners should be more vigilant about unexpected rates of chemotherapy adverse events when switching to a different manufacturer's product. We have also observed an association between severe post-treatment leukopenia and the development of IIE, which has not been reported previously.

Original languageEnglish
Pages (from-to)235-238
Number of pages4
JournalAnti-Cancer Drugs
Issue number3
StatePublished - 1 Mar 2016


  • Different formulation
  • Encephalopathy
  • Ifosfamide
  • Leukopenia
  • Neurotoxicity


Dive into the research topics of 'Severe post-treatment leukopenia associated with the development of encephalopathy following ifosfamide infusion'. Together they form a unique fingerprint.

Cite this