Incidence of hemorrhagic cystitis after cyclophosphamide therapy with or without mesna: A cohort study and comprehensive literature review

Background Cyclophosphamide is an alkylating agent associated with significant toxicities, most importantly hemorrhagic cystitis. Many approaches including mesna use were established to reduce this toxicity. However, data on mesna efficacy are conflicting. Objective To investigate the incidence of h...

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Bibliographic Details
Published in:Journal of oncology pharmacy practice 2021-03, Vol.27 (2), p.340-349
Main Authors: Almalag, Haya M, Alasmari, Sarah S, Alrayes, Mounerah H, Binhameed, Munirah A, Alsudairi, Reem A, Alosaimi, Maha M, Alnasser, Ghada A, Abuzaid, Rawan A, Khalil, Najma, Abouzaid, Hanan H, Alarfaj, Abdulrahman S
Format: Article
Language:English
Subjects:
Adult
Antineoplastic Agents, Alkylating - administration & dosage
Antineoplastic Agents, Alkylating - adverse effects
Cohort Studies
Cyclophosphamide - administration & dosage
Cyclophosphamide - adverse effects
Cystitis - chemically induced
Cystitis - prevention & control
Female
Hemorrhage - chemically induced
Hemorrhage - prevention & control
Humans
Male
Mesna - therapeutic use
Middle Aged
Prospective Studies
Protective Agents - therapeutic use
Retrospective Studies
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Summary:Background Cyclophosphamide is an alkylating agent associated with significant toxicities, most importantly hemorrhagic cystitis. Many approaches including mesna use were established to reduce this toxicity. However, data on mesna efficacy are conflicting. Objective To investigate the incidence of hemorrhagic cystitis in patients receiving cyclophosphamide therapy with or without mesna. Methods A retrospective chart review was done on all adult patients receiving cyclophosphamide therapy with or without mesna at the King Saud University Medical City. The incidence of hemorrhagic cystitis was recorded. Patients receiving mesna were compared with those not receiving mesna. Data were reported as numbers and percentages, and appropriate statistical tests of association were used. This step was followed by a comprehensive literature review using appropriate keywords in PubMed from the inception of the database until August 2019. All studies of interest were reported. Results A total of 718 patients’ medical records were reviewed. The majority of the patients received mesna (n = 433, 60%). The mesna group had a greater incidence of hemorrhagic cystitis (3.5% vs. 0.4%, p 
ISSN:1078-1552
1477-092X
DOI:10.1177/1078155220920690