Carboplatin Area Under the Curve dosing in pediatric patients: influence of glomerular filtration rate measurement

Abstract Introduction: Carboplatin dosage methods are often based on renal clearance. An accurate determination of the glomerular filtration rate (GFR) can be obtained by measuring 51Cr-EDTA clearance; however, this method is laborious. For that matter, various formulae have been developed to estimate the GFR. The aim of this study is to compare carboplatin doses calculated by Mann/Pein formula with GFR measured by 51Cr-EDTA clearance and GFR estimated with Schwartz formulae in children. Methods: All cancer paediatric patients whose GFR was measured by 51Cr-EDTA were included. GFR was also estimated with Schwartz formulae. To calculate carboplatin dose, Mann/Pein formula was used. A target Area Under the Curve (AUC) of 5 mg/ml/min was chosen. Carboplatin doses were calculated with two different values of GFR calculated previously. Results: A total of 33 patients were identified with a median age of 10 years old (range 1-17), 63.6% were males. The median weight, height and BSA were 28 kg (range 8-84.4 kg), 137 cm (range 64-182 cm) and 1.04 m2 (range 0,37-2,1 m2) respectively. The mean of carboplatin doses calculated with GFR measured by 51Cr-EDTA was 274.3±135.7 mg and with GFR estimated with Schwartz formulae was 364.9±156.6 mg. The mean difference between methods was 90.6 mg, P<0.001. Conclusion: Carboplatin doses calculated with GFR estimated by Schwartz were statistically higher than those measured with 51Cr-EDTA. This variability may be a risk factor leading to inadequate dosage of patients treated with carboplatin.

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Bibliographic Details
Main Authors: Báez-Gutiérrez,N, Rodríguez-Ramallo,H, Iglesias-Jerez,R, Álvarez-del Vayo,Benito C
Format: Digital revista
Language:English
Published: Organización de Farmacéuticos Ibero-Latinoamericanos 2022
Online Access:https://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1699-714X2022000200010
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