Methylene Blue for Ifosfamide-Associated Encephalopathy

Abstract

To the Editor: Ifosfamide is a chemotherapeutic agent used in the treatment of cervical carcinoma, soft-tissue sarcomas, and germ-cell tumors. Myelosuppression is common. Hemorrhagic cystitis is prevented by the administration of mesna. Confusion and coma have been associated with the use of ifosfamide, and antiepileptic drugs may be required.1 Ifosfamide may also cause a dose-dependent encephalopathy in the presence of a pelvic mass that obstructs the ureters or intrinsic renal impairment.2 The drug is marketed in the United States as Ifex (Bristol-Myers Oncology Division, Princeton, N.J.). We report the reversal of ifosfamide-associated encephalopathy with methylene blue in a 68-year-old woman. © 1995, Massachusetts Medical Society. All rights reserved.