RT Journal Article
SR Electronic
T1 Incidence of Cyclophosphamide-induced Urotoxicity and Protective Effect of Mesna in Rheumatic Diseases
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 1661
OP 1666
DO 10.3899/jrheum.150065
VO 42
IS 9
A1 Neslihan Yilmaz
A1 Hakan Emmungil
A1 Sercan Gucenmez
A1 Gulsen Ozen
A1 Fatih Yildiz
A1 Ayşe Balkarli
A1 Gezmis Kimyon
A1 Belkis Nihan Coskun
A1 Ismail Dogan
A1 Omer Nuri Pamuk
A1 Sule Yasar
A1 Gozde Yildirim Cetin
A1 Ayten Yazici
A1 Serpil Ergulu Esmen
A1 Yonca Cagatay
A1 Sema Yilmaz
A1 Ayse Cefle
A1 Mehmet Sayarlioglu
A1 Timucin Kasifoglu
A1 Omer Karadag
A1 Yavuz Pehlivan
A1 Ediz Dalkilic
A1 Bunyamin Kisacik
A1 Veli Cobankara
A1 Eren Erken
A1 Haner Direskeneli
A1 Kenan Aksu
A1 Sule Yavuz
YR 2015
UL http://www.jrheum.org/content/42/9/1661.abstract
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.