How do you manage patients with a history of severe ifosfamide neurotoxicity who need additional ifosfamide?  

Ifosfamide neurotoxicity is an idiosyncratic reaction. Methylene blue has been shown to be effective in this situation but has not been studied prophylactically. Given that there are no evidence-based guidelines for re-challenging a patient with prior ifosfamide neurotoxicity who again requires the ...