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What is Thiotepa
Thiotepa is an alkylating agent indicated for the treatment of superficial papillary carcinoma of the urinary bladder, ovarian cancer, breast cancer, Hodgkin lymphoma, non-Hodgkin lymphoma, and controlling intracavitary effusions secondary to diffuse or localized neoplastic diseases of various serosal cavities.
Thiotepa was originally approved by the FDA in 1959.
In 2017, Thiotepa (Tepadina) was approved by the FDA to reduce the risk of graft rejection when used in conjunction with high-dose busulfan and cyclophosphamide as a preparative regimen for allogeneic hematopoietic progenitor cell transplantation for pediatric patients with class 3 beta-thalassemia.
Brand Name
TEPADINA
Indications
- bladder cancer
- bone marrow transplant rejection
- breast cancer
- carcinomatous meningitis
- Hodgkin lymphoma
- non-Hodgkin’s lymphoma (NHL)
- ovarian cancer
- pericardial effusion
- peritoneal effusion
- pleural effusion
- soft-tissue sarcoma
- stem cell transplant preparation
Side Effects
- abdominal pain
- alopecia
- amenorrhea
- amnesia
- anaphylactic shock
- anaphylactoid reactions
- anemia
- anorexia
- aphasia
- ascites
- bleeding
- blurred vision
- bone marrow suppression
- bradycardia
- breast cancer
- capillary leak syndrome
- cardiac arrest
- coma
- confusion
- conjunctivitis
- contact dermatitis
- cranial nerve palsies
- cystitis
- delirium
- depression
- diarrhea
- dizziness
- drowsiness
- dysphagia
- dyspnea
- dysuria
- elevated hepatic enzymes
- elevated hepatic enzymes
- encephalopathy
- enterocolitis
- exfoliative dermatitis
- fatigue
- fever
- gastritis
- GI bleeding
- graft-versus-host disease (GVHD)
- hallucinations
- headache
- hearing loss
- heart failure
- hematuria
- hemorrhagic cystitis
- hepatomegaly
- hyperbilirubinemia
- hyperbilirubinemia
- hyponatremia
- hypotonia
- immunosuppression
- infection
- infection
- influenza
- injection site reaction
- intracranial bleeding
- laryngeal edema
- leukemia
- leukoencephalopathy
- lymphoma
- maculopapular rash
- malaise
- memory impairment
- nausea
- neurotoxicity
- neutropenia
- new primary malignancy
- palmar-plantar erythrodysesthesia (hand and foot syndrome)
- papilledema
- pericardial effusion
- pericarditis
- pneumonitis
- post-transplant lymphoproliferative disorder (PTLD)
- prolonged bleeding time
- pruritus
- ptosis
- pulmonary hypertension
- pulmonary toxicity
- rash
- renal failure (unspecified)
- respiratory arrest
- seizures
- sinusitis
- sinusoidal obstruction syndrome (SOS)
- spermatogenesis inhibition
- Stevens-Johnson syndrome
- stomatitis
- stomatitis
- stroke
- subdural hematoma
- suicidal ideation
- thrombocytopenia
- toxic epidermal necrolysis
- tremor
- urinary retention
- urticaria
- veno-occlusive disease (VOD)
- visual impairment
- vomiting
- weakness
- weight gain
- wheezing
Monitoring Parameters
- CBC with differential
- LFTs
- pregnancy testing
- serum creatinine/BUN
Contraindications
- anemia
- bleeding
- bone marrow suppression
- breast-feeding
- coma
- contraception requirements
- encephalopathy
- hepatic disease
- infection
- infertility
- intracranial bleeding
- male-mediated teratogenicity
- neonates
- neutropenia
- new primary malignancy
- pregnancy
- pregnancy testing
- radiation therapy
- renal impairment
- reproductive risk
- seizures
- sepsis
- serious rash
- sinusoidal obstruction syndrome (SOS)
- thrombocytopenia
- vaccination
- veno-occlusive disease (VOD)
Monitoring Parameters
- CBC with differential
- LFTs
- pregnancy testing
- serum creatinine/BUN
Contraindications
- anemia
- bleeding
- bone marrow suppression
- breast-feeding
- coma
- contraception requirements
- encephalopathy
- hepatic disease
- infection
- infertility
- intracranial bleeding
- male-mediated teratogenicity
- neonates
- neutropenia
- new primary malignancy
- pregnancy
- pregnancy testing
- radiation therapy
- renal impairment
- reproductive risk
- seizures
- sepsis
- serious rash
- sinusoidal obstruction syndrome (SOS)
- thrombocytopenia
- vaccination
- veno-occlusive disease (VOD)