PT  - JOURNAL ARTICLE
AU  - Neslihan Yilmaz
AU  - Hakan Emmungil
AU  - Sercan Gucenmez
AU  - Gulsen Ozen
AU  - Fatih Yildiz
AU  - Ayşe Balkarli
AU  - Gezmis Kimyon
AU  - Belkis Nihan Coskun
AU  - Ismail Dogan
AU  - Omer Nuri Pamuk
AU  - Sule Yasar
AU  - Gozde Yildirim Cetin
AU  - Ayten Yazici
AU  - Serpil Ergulu Esmen
AU  - Yonca Cagatay
AU  - Sema Yilmaz
AU  - Ayse Cefle
AU  - Mehmet Sayarlioglu
AU  - Timucin Kasifoglu
AU  - Omer Karadag
AU  - Yavuz Pehlivan
AU  - Ediz Dalkilic
AU  - Bunyamin Kisacik
AU  - Veli Cobankara
AU  - Eren Erken
AU  - Haner Direskeneli
AU  - Kenan Aksu
AU  - Sule Yavuz
TI  - Incidence of Cyclophosphamide-induced Urotoxicity and Protective Effect of Mesna in Rheumatic Diseases
AID  - 10.3899/jrheum.150065
DP  - 2015 Sep 01
TA  - The Journal of Rheumatology
PG  - 1661--1666
VI  - 42
IP  - 9
4099  - http://www.jrheum.org/content/42/9/1661.short
4100  - http://www.jrheum.org/content/42/9/1661.full
SO  - J Rheumatol2015 Sep 01; 42
AB  - Objective. To assess bladder toxicity of cyclophosphamide (CYC) and uroprotective effect of mesna in rheumatic diseases.Methods. Data of 1018 patients (725 women/293 men) treated with CYC were evaluated in this retrospective study. All of the following information was obtained: the cumulative CYC dose, route of CYC administration, duration of therapy, concomitant mesna usage, and hemorrhagic cystitis. Cox proportional hazard model was used for statistics.Results. We identified 17 patients (1.67%) with hemorrhagic cystitis and 2 patients (0.19%) with bladder cancer in 4224 patient-years. The median time for diagnosis to hemorrhagic cystitis was 10 months (4–48) and bladder cancer was 8 years (6–10.9). There were 583 patients (57.2%) who received mesna with intravenous CYC therapy. We observed similar incidence rate for hemorrhagic cystitis in both patient groups concomitantly treated with or without mesna [9/583 (1.5%) vs 8/425 (1.8%) respectively, p = 0.08]. Cumulative CYC dose (HR for 10-g increments 1.24, p < 0.001) was associated with hemorrhagic cystitis.Conclusion. Cumulative dose was the only risk factor for hemorrhagic cystitis in patients treated with CYC. No proof was obtained for the uroprotective effect of mesna in our cohort.