Hemorrhagic cystitis occurs in 40-60% of patients receiving cyclophosphamide therapy. Name the causative xenobiotic. Name the drug that is often given to reduce this.
1. Acrolein.
2. Mesna.
Mesna is given with either cyclophosphamide or ifofsamide to reduce hemorrhagic cystitis however the data on the efficacy of mesna is limited. A recent retrospective review of 718 patients of which 433 received mesna did not show a benefit of mesna. The authors did find that higher doses of cyclophosphamide was associated with high incidence of hemorrhagic cystitis. Additional studies are needed to evaluate the role of mesna in preventing hemorrhagic cystitis.
Almalag HM et al. Incidence of hemorrhagic cystitis after cyclophosphamide therapy with or without mesna: A cohort study and comprehensive literature review. Journal of Oncology Pharmacy Practice. Published online May 1 2020. https://doi.org/10.1177/1078155220920690