Also Known As: Ifex®
Late Effect (1st of 4)
- Decreased functioning of the ovaries in females or testes in males (hypogonadism)
- Infertility
- Early menopause
Your risk is greater if:
- You are male.
- You are female and were treated during or after puberty.
- It was combined with
- Other alkylating agents
- Radiation to the testicles, pelvis, or total body
- You received a high dose of the drug.
Recommended Evaluation
- History and physical exam, especially sexual history in males and menstrual history in females yearly
- Hormone levels (females - FSH, LH, estradiol; males - LH, FSH, testosterone), and semen analysis as indicated based on need
Management
- Because of the risk of early menopause, females should carefully weigh a decision to delay childbearing.
- You may need a referral to a reproductive endocrinologist for fertility concerns. Sometimes, recovery of fertility may occur spontaneously many years after treatment.
- Your doctor may recommend a bone mineral density to see if you have osteopenia or osteoporosis.
- You may benefit from hormone replacement therapy; discuss it with your doctor.
Late Effect (2nd of 2)
Acute myeloid leukemia (AML)
Your risk is greater if:
- It has been less than 10 years since you finished treatment. (It is more common in first 10 years.)
- You received a high cumulative dose or if you also received other alkylating agents, especially melphalan or mechlorethamine.
Recommended Evaluation
- Physical exam yearly
- Complete blood count and differential yearly for up to 15 years
- Evaluation of symptoms of fatigue, pallor, petechiae (small red rash), and bone pain
- A bone marrow exam if you have any symptoms.
Management
- If you are diagnosed with AML, you will be referred to a medical or pediatric oncologist for treatment.
Late Effect (3rd of 4)
Bladder problems (bleeding, dysfunctional voiding, malignancy)
Your risk is greater if:
- You also received radiation to the pelvis.
- You received a high dose.
- You had bleeding from your bladder during treatment.
- You drink alcoholic beverages.
- You use tobacco.
Recommended Evaluation
- Urinalysis yearly
- Evaluation of painful urination or blood in the urine
Management
- You may need a urology consultation.
Late Effect (4th of 4)
Kidney problems (possibly leading to kidney failure)
Your risk is greater if:
- You received a dose greater than 60 gm/m².
- You were younger than 5 years when you were treated.
- You also received other drugs that can harm your kidneys (e.g., cisplatin, carboplatin, amphotericin B).
- The tumor invaded the kidney.
- If you have had kidney problems unrelated to your cancer diagnosis or treatment.
Recommended Evaluation
- Blood pressure yearly
- Blood tests of your kidney function at the end of treatment and repeated yearly
- Immediate evaluation for symptoms of a urinary tract infection
Management
- Drink plenty of fluids.
- You may need to take electrolyte supplements.
- Discuss any new medication, supplements, or herbals with a doctor who is knowledgeable about the side effects of ifosfamide before taking them.
- You may need a referral to a kidney specialist (nephrologist).
