Treatment of Resistant Cyclophosphamide Induced Haemorrhagic Cystitis: Review of Literature and Three Case Reports
Published: April 1, 2016 | DOI: https://doi.org/10.7860/JCDR/2016/.7642
Turgay Ebiloglu, Engin Kaya, Sercan Yilmaz, Gökhan Özgür, Yusuf Kibar
1. Faculty, Department of Urology, Etimesgut Military Hospital, Ankara, Turkey.
2. Faculty, Department of Urology, Section of Pediatric Urology, Gulhane Military Medical Academy, Ankara, Turkey.
3. Faculty, Department of Urology, Section of Pediatric Urology, Gulhane Military Medical Academy, Ankara, Turkey.
4. Faculty, Department of Heamatology, Gulhane Military Medical Academy, Ankara, Turkey.
5. Faculty, Department of Urology, Section of Pediatric Urology, Gulhane Military Medical Academy, Ankara, Turkey.
Correspondence
Dr. Turgay Ebiloglu,
Etimesgut Military Hospital, Department of Urology, 06010 Etimesgut/Ankara, Turkey.
E-mail: drturgayebiloglu@gmail.com
Haemorrhagic Cystitis (HC) is defined as diffuse inflammatory bladder bleeding due to many aetiologies. Massive HC often arises from anticancer chemotherapy or radiotherapy for the treatment of pelvic malignancies. Phosphamides are the anti-cancer drugs used for treating breast cancer, B-cell lymphoma, leukemia, rheumatoid arthritis and systemic lupus erythaematosis by cross-linking strands of DNA and preventing the cell division. They are also used in bone marrow transplantation for prevention of Graft Versus Host Disease (GVHD). Hepatic metabolism of phosphamide forms acrolein, and acrolein makes ulceration, haemorrhage, edema and necrosis of the urothelium during its excretion by the urine. Infectious causes of HC in immunocomprimesed patients are adenovirus, BK polyoma-virus (BK), JC virus, and Cytomegalovirus (CMV). The present article attempts to make a review of literature for the treatment of intractable HC and report three cases with HC.
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