We studied the incidence of myelosuppression and renal function in 33 patients treated by repeated resections of bladder tumors and thiotepa instillations for at least 26 months in the presence of vesicoureteral reflux. Of the 33 patients 28 had unilateral and 5 had bilateral reflux. Transient myelosuppression occurred in 5 patients (15.1 per cent), including 2 with bilateral reflux. Renal function remained stable in all but 2 patients who had decreased renal function when thiotepa was started. Our experience has shown that long-term thiotepa instillation in the presence of vesicoureteral reflux is relatively safe, with no significantly increased incidence of myelosuppression and no detrimental effect on renal function.
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