Neslihan Yilmaz1, Hakan Emmungil1, Sercan Gucenmez1, Gulsen Ozen1, Fatih Yildiz1, Ayşe Balkarli1, Gezmis Kimyon1, Belkis Nihan Coskun1, Ismail Dogan1, Omer Nuri Pamuk1, Sule Yasar1, Gozde Yildirim Cetin1, Ayten Yazici1, Serpil Ergulu Esmen1, Yonca Cagatay1, Sema Yilmaz1, Ayse Cefle1, Mehmet Sayarlioglu1, Timucin Kasifoglu1, Omer Karadag1, Yavuz Pehlivan1, Ediz Dalkilic1, Bunyamin Kisacik1, Veli Cobankara1, Eren Erken1, Haner Direskeneli1, Kenan Aksu1, Sule Yavuz1. 1. From the Rheumatology Department, Faculty of Medicine, Istanbul Bilim University; Rheumatology Department, Faculty of Medicine, Marmara University, Istanbul; Rheumatology Department, Faculty of Medicine, Ege University, İzmir; Rheumatology Department, Faculty of Medicine, Cukurova University, Adana; Rheumatology Department, Faculty of Medicine, Pamukkale University, Denizli; Faculty of Medicine, Gaziantep Rheumatology University, Gaziantep; Rheumatology Department, Faculty of Medicine, Uludag University, Bursa; Rheumatology Department, Faculty of Medicine, Hacettepe University, Ankara; Rheumatology Department, Faculty of Medicine, Trakya University, Edime; Rheumatology Department, Faculty of Medicine, Eskişehir Osmangazi University, Eskişehir; Rheumatology Department, Faculty of Medicine, Kahramanmaraş Sütçüimam University, Kahramanmaraş; Rheumatology Department, Faculty of Medicine, Kocaeli University, İzmit; Rheumatology Department, Faculty of Medicine, Selçuk University, Konya, Turkey.N. Yilmaz, MD, Associate Professor, Rheumatology Department, Faculty of Medicine, Istanbul Bilim University; H. Emmungil, MD; S. Gucenmez, MD, Rheumatology Department, Faculty of Medicine, Ege University; G. Ozen, MD, Rheumatology Department, Faculty of Medicine, Marmara University; F. Yildiz, MD, Rheumatology Department, Faculty of Medicine, Cukurova University; A. Balkarli, MD, Rheumatology Department, Faculty of Medicine, Pamukkale University; G. Kimyon, MD, Faculty of Medicine, Gaziantep Rheumatology University; B.N. Coskun, MD, Rheumatology Department, Faculty of Medicine, Uludag University; I. Dogan, MD, Rheumatology Department, Faculty of Medicine, Hacettepe University; O.N. Pamuk, MD, Rheumatology Department, Faculty of Medicine, Trakya University; S. Yasar, MD, Rheumatology Department, Faculty of Medicine, Eskişehir Osmangazi University; G.Y. Cetin, MD, Rheumatology Department, Faculty of Medicine, Kahramanmaraş Sütçüimam University; A. Yazici, MD, Associate
Abstract
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.
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.
Authors: Mosad A Ghareeb; Mansour Sobeh; Walaa H El-Maadawy; Hala Sh Mohammed; Heba Khalil; Sanaa Botros; Michael Wink Journal: Antioxidants (Basel) Date: 2019-09-19
Authors: Anna Merwid-Ląd; Piotr Ziółkowski; Marta Szandruk-Bender; Agnieszka Matuszewska; Adam Szeląg; Małgorzata Trocha Journal: Pharmaceuticals (Basel) Date: 2021-11-29