Cyclophosphamide
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Haemorrhagic cystitis: 9 case reports A retrospective study described 9 patients (4 females and 5 males) aged 4–30 years who developed haemorrhagic cystitis following the administration of high dose cyclophosphamide as conditioning regimen prior to haematopoetic stem cell transplantation (HSCT). The patients with Thalassaemia major, aplastic anaemia with paroxysmal nocturnal haemoglobinuria, minimal residual disease plus acute lymphoblastic leukaemia or Fanconi’s aplastic anaemia were scheduled to undergo haematopoetic stem cell transplantation. All the patients received conditioning regimen prior to the procedure that consisted of cyclophosphamide [route and dosage not stated]. In addition to cyclophosphamide, the patients received busulfan (4 patients), flucytosine (2 patients) or both busulfan and flucytosine (3 patients) as conditioning regimen. All the patients received prophylaxis for haemorrhagic cystitis and levofloxacin prophylaxis prior to the HSCT. However, 6–66 days after the procedure, all the 9 patients developed haemorrhagic cystitis [duration of treatment to time to reaction onset not stated]. The haemorrhagic cystitis was noted as grade III in 6 patients, grade II in 2 patients and grade I in one patient. Subsequently, the patients received treatment with hydration, blood component support, bladder irrigation or intravesicular molgramostim [recombinant human-granulocyte macrophage colony-stimulating factor]. Six patients achieved complete remission with the treatment. Three patients failed to respond despite 3 days of treatment with molgramostim [not all outcomes stated]. Dasgupta R, et al. Role of intravesical rh-GMCSF in controlling haemorrhagic cystitis in patients undergoing HSCT. Indian Journal of Hematology and Blood Transfusion 35 803503166 (Suppl.): S131 abstr. 8, No. 1, 2019. Available from: URL: http://doi.org/10.1007/s12288-019-01207-5 [abstract]
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Reactions 26 Sep 2020 No. 1823
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