Ifosfamide ±VP16 in Childhood' Malignancy

all to patients receiving additional VP16. Nadir neutrophil counts fell below 0.5x109/L in 42% of the single agent group and 69% of the two agent group. There were no documented bacteraemias. Nadir platelet count fell below 50x109/L in 6 cases (combined therapy); only one platelet transfusion was required, for a minor bleeding episode. There were no episodes of frank haematuria. The higher dose of MESNA did not confer protection against microscopic haematuria. Emesis occurred in all but two patient courses, but was considered of comparable severity to other non-platinum containing regimens. Two patients had a generalized convulsion, both with full recovery. There was no demonstrable renal or hepatic toxicity. We conclude that these regimens have acceptable toxicity in the context of the high risk patients treated and the alternative available treatment options.