Comparison of mesna with forced diuresis to prevent cyclophosphamide induced haemorrhagic cystitis in marrow transplantation: a prospective randomised study

Hows, Jill; Mehta, Amrish; Ward, LC; Woods, Katy; Pérez, R; Gordon, M. Y.; Gordon‐Smith, E. C.

doi:10.1038/bjc.1984.252

Cited by 100 publications

(52 citation statements)

References 10 publications

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“…Over the past decades, outcome of early-onset HC is largely improved by the use of 2-mercaptoethane sulfonate sodium (mesna), hyperhydration and forced diuresis. 32,33 In contrast, LOHC remains a continuing complication for HSCT, which is thought to result mainly from viral infections. The reactivation of polyomavirus such as BK virus has been thought to be the most significant factor in the pathogenesis of LOHC, some other studies provide information of adenovirus, CMV and simian virus 40 as putative agents of HC.…”

Section: Discussionmentioning

confidence: 99%

Selective embolization of the internal iliac arteries for the treatment of severe hemorrhagic cystitis following hematopoietic SCT

Han

Sun

et al. 2008

Bone Marrow Transplant

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Section: Discussionmentioning

confidence: 99%

Selective embolization of the internal iliac arteries for the treatment of severe hemorrhagic cystitis following hematopoietic SCT

Han

Sun

et al. 2008

Bone Marrow Transplant

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“…The prevention of HC includes sufficient oral and parenteral hydration. [7][8][9][10] Hows et al 20 reported a lower incidence of cyclophosphamide-induced HC in marrow transplantation with 2-mercaptoethane sulfonate (mesna). Mesna binds to acrolein, which is responsible for urothelial toxicity as a urinary metabolite of cyclophosmamide.…”

Section: Discussionmentioning

confidence: 99%

Encouraging results in the treatment of haemorrhagic cystitis with estrogen – report of 10 cases and review of the literature

Ordemann

Naumann

Geissler

et al. 2000

Bone Marrow Transplant

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Summary:Haemorrhagic cystitis (HC) after allogeneic haematopoietic stem cell transplantation (HSCT) or high-dose cyclophosphamide (CP) chemotherapy is a severe sideeffect and can cause significant morbidity and mortality. In this report, we describe the clinical courses of 10 patients with HC and review the literature. The patients were treated with oral conjugated estrogen in an attempt to improve severe haemorrhagic cystitis. In seven patients positive effects were seen, haematuria resolved in all, but residual symptoms of dysuria remained for longer periods. In one patient application of estrogen was interrupted because of hepatotoxicity. Two patients failed all treatment modalities including oral estrogen because of terminal illness. We conclude that in the management of HC the administration of oral conjugated estrogen should be considered. Bone Marrow Transplantation (2000) 25, 981-985.

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“…The time interval between the last dose of BU and the first dose of CY was not 424 h. They were also given appropriate hydration during the period of conditioning along with 2-mercaptoethanesulfonate at 140% of the dose of CY in seven equally divided doses during CY infusion days for prevention of hemorrhagic cystitis. 34 None of the patients received ursodiol for prophylaxis of SOS. All patients were risk stratified as per the Lucarelli classification, 33 and liver function as well as hepatitis B and C virus infections were assessed before transplant.…”

Section: Patients and Methods Patientsmentioning

confidence: 99%

Population pharmacokinetics of cyclophosphamide in patients with thalassemia major undergoing HSCT

Balasubramanian

Desire

Panetta

et al. 2012

Bone Marrow Transplant

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CY in combination with BU is a widely used conditioning regimen for haematopoietic SCT (HSCT). The aim of this study was to evaluate the pharmacokinetics (PK) of CY and its major metabolite 4-hydroxyCY (HCY) in patients with thalassemia undergoing HSCT. A total of 55 patients received BU (16 mg/kg) followed by CY (160 --200 mg/kg) both over 4 days before HSCT. A population PK model was developed to describe the disposition of CY and HCY and the inter-individual (IIV) and inter-occasion variability (IOV). The model was also used to determine the effects covariates including: demographics, Lucarelli classification and polymorphisms in enzymes involved in the metabolism or biotransformation of CY had on CY and HCY disposition. Overall, 17 --114% IIV and 12 --103% IOV in CY and HCY PK parameters were observed. Body weight and age were the main covariates, which explained the largest portion of the IIV. In addition, CYP2C9*2 explained a significant portion of the IIV in the clearance (Po0.002) and thus the area under the concentration curve (Po0.05) of CY. This covariate model may be used to design and plan targeted dose therapy in this group of pediatric patients, if clinical outcome association with CY PK are proved and target range established.Bone Marrow Transplantation (2012) 47, 1178 --1185; doi:10.1038/bmt.2011.254; published online 9 January 2012Keywords: CY; pharmacokinetics; thalassemia, HSCT INTRODUCTION CY in combination with BU has been a commonly used conditioning regimen in HSCT for malignant and non-malignant diseases. 1 --3 Even though advances in transplantation practices including reducing the intensity of the conditioning regimen have improved the outcome of HSCT in recent years, 4,5 doselimiting toxicities such as sinusoidal obstruction syndrome (SOS) and hemorrhagic cystitis 6,7 remain as the major problems associated with BU-CY-based myeloablative-conditioning regimen. We and others have previously shown that BU pharmacokinetics (PK) influences toxicity and outcome associated with HSCT in patients with thalassemia major treated with BU/CY conditioning. 8 --10 The PK and pharmacodynamics of CY in pediatric patients receiving myeloablative doses of CY are limited and to the best of our knowledge, there is no report on CY PK in pediatric patients undergoing HSCT with myeloablative BU/CY-conditioning regimen. A recent study on the PK of CY and its metabolites in pediatric patients receiving high-dose myeloablative therapy 11 showed very little inter-patient variation in CY elimination, which is largely accounted for by body surface area, suggesting that high-dose chemotherapy resulted in minimal differences in CY PK as compared with more conventional dosage regimens. A population PK model was developed for the first time in children with neuroblastoma, 12 which showed substantial inter-patient variability in the PK of CY and its metabolites. Neither of these two studies described any pharmacodynamics associations. Several studies in adult patients have shown association between the incidence of SO...

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Comparison of mesna with forced diuresis to prevent cyclophosphamide induced haemorrhagic cystitis in marrow transplantation: a prospective randomised study

Cited by 100 publications

References 10 publications

Selective embolization of the internal iliac arteries for the treatment of severe hemorrhagic cystitis following hematopoietic SCT

Selective embolization of the internal iliac arteries for the treatment of severe hemorrhagic cystitis following hematopoietic SCT

Encouraging results in the treatment of haemorrhagic cystitis with estrogen – report of 10 cases and review of the literature

Population pharmacokinetics of cyclophosphamide in patients with thalassemia major undergoing HSCT

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