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430 Chapter 7: Solid Tumors<br />

E<br />

100<br />

0 10 20<br />

Time (hrs)<br />

thioTEPA<br />

Figure 3. Plasma concentration versus time curves of three alkylating agents on the first<br />

day of a tCTC course. A: Plasma concentration of TEPA <strong>and</strong> thiotepa vs. time curves of two<br />

patients. Both had received a thiotepa dose of 40 mg/m 2<br />

. B: Plasma concentration of<br />

cyclophosphamide vs. time curves of two patients after their first dose of 1000 mg/m 2<br />

cyclophosphamide.<br />

cause mortality. However, this type of toxicity continues to be of major concern.<br />

Experience with this treatment strategy is still limited, <strong>and</strong> severe hemorrhagic<br />

cystitis or lethal veno-occlusive disease may occur when larger numbers of patients<br />

have been studied. These toxicities are, however, observed in only a minority of<br />

patients <strong>and</strong> may, in part, result from pharmacokinetic variability between patients.<br />

TEPA

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