Cyclophosphamide Hemorrhagic Cystitis

Liedberg, Carl-Fredrik; Rausing, Alf; Langeland, Per

doi:10.3109/00365597009137596

Cited by 30 publications

(6 citation statements)

References 6 publications

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“…Hemorrhagic cystitis is characterized by bladder pain as well as bladder bleeding. 61 PGI 2 has the ability to sensitize sensory neurons and cause hyperalgesia. 62,63 IP receptors have been reported to be highly involved in nociception through their activation of the sensory nerves and dorsal root ganglion (DRG) neurons.…”

Section: Discussionmentioning

confidence: 99%

Absence of prostacyclin greatly relieves cyclophosphamide‐induced cystitis and bladder pain in mice

et al. 2021

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Cyclophosphamide (CP) has been widely used in the treatment of various malignancies and autoimmune diseases, but acrolein, a byproduct of CP, causes severe hemorrhagic cystitis as the major side effect of CP. On the other hand, a large amount of prostacyclin (PGI 2 ) is produced in bladder tissues, and PGI 2 has been shown to play a critical role in bladder homeostasis. PGI 2 is biosynthesized from prostaglandin (PG) H 2 , the common precursor of PGs, by PGI 2 synthase (PTGIS) and is known to also be involved in inflammatory responses. However, little is known about the roles of PTGIS-derived PGI 2 in bladder inflammation including CP-induced hemorrhagic cystitis. Using both genetic and pharmacological approaches, we here revealed that PTGIS-derived PGI 2 -IP (PGI 2 receptor) signaling exacerbated CP-induced bladder inflammatory reactions. Ptgis deficiency attenuated CP-induced vascular permeability and chemokine-mediated neutrophil migration into bladder tissues and then suppressed hemorrhagic cystitis. Treatment with RO1138452, an IP selective antagonist, also suppressed CP-induced cystitis. We further found that cystitis-related nociceptive behavior was also relieved in both Ptgis −/− mice and RO1138452-treated mice. Our findings may provide new drug targets for bladder inflammation and inflammatory pain in CP-induced hemorrhagic cystitis.

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Section: Discussionmentioning

confidence: 99%

Absence of prostacyclin greatly relieves cyclophosphamide‐induced cystitis and bladder pain in mice

et al. 2021

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“…[68][69][70] Cyclophosphamide effects are potentiated by radiation, with one study in children showing that 8% of patients who had radiation outside the pelvis demonstrated therapy-induced cystitis, whereas 34% of patients who had radiation directed at the pelvis demonstrated therapy-induced cystitis. 71 Intravesical immunochemotherapy with BCG may cause granulomatous cystitis.…”

Section: Therapy-induced Cystitismentioning

confidence: 99%

Benign Diseases of the Bladder

Coleman

Hansel

2008

Surgical Pathology Clinics

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“…Also, bladder fibrosis appeared only in patients treated by a dose of 6.0 gm/m2 or larger. Furthermore, the appearance of hemorrhagic cystitis within 24 hours of large doses of intravenous CTX, either in animal ex,ierinients or in patients, after high cumulative doses, suggest dose correlation [Berkson et al 1973;Hall, 1967;Liedberg et al, 1970;Philips et al, 19611. However, the correlation of drug dosage with bladder damage is a complex question and can be influenced by various factors, including drug dose; route and frequency of administration: functional properties of the liver, kidney, and intestinal tract; and the status of hydration.…”

Section: Case Reportmentioning

confidence: 99%

“…Occasionally cases of hemorrhagic cystitis occur soon after the intravenous injection -ie, within a few days or even 24 hours; but in the majority of cases, hemorrhagic cystitis occurs after a few weeks, or longer of CTX therapy, [Fernbach et al? 1962;Liedberg et al, 1970;Sweeney et al, 19621. A few cases were described in which the symptoms appeared months after the therapy was stopped [Forni et al, 1964;Lawrence et al, 19751 .…”

Section: Case Reportmentioning

confidence: 99%

“…Reinstitution of CTX following the cessation of urinary difficulty generally results in recurrence of the hemorrhagic cystitis [ Fernbad1 et al, 1962;Lawrence et al, 19751. Hemorrhagic cystitis can be marked with severe and prolonged bleeding requiring multiple blood transfusions or surgery; in a few patients, death resulted from the hemorrhagic cystitis [Berkson et al, 1973;Lawrence et al, 1975;Liedberg et al, 1970;Spechter et al, 19651 .…”

Section: Case Reportmentioning

confidence: 99%

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Chronic hematuria and localized bladder damage following combined cyclophosphamide and local radiotherapy

Kende

Wajsman

Thomas

et al. 1979

Journal of Surgical Oncology

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A 13-year-old white male had Ewing sarcoma of the right pubic and ischial bones. Initial therapy consisted of 5,400 rads in seven weeks to the right side of the pelvis and 14 intravenous injections of cyclophosphamide (Cytoxan, CTX) at 500 mg/m2; BCNU and Adriamycin maintenance therapy continued for a total of two years. He has now been disease-free for five years. Three months following the completion of the right pelvic radiotherapy (RT), while on intravenous CTX, severe hematuria appeared, which subsided, but at present he has continuous microscopic hematuria, as well as periodic episodes of gross hematuria. Serial cystocopies initially revealed thickening and hemorrhagic and edematous changes on the right (irradiated) side of the bladder, and recent multiple telangiectatic patches have been demonstrated as a late "healing" phase. This case demonstrates the additive toxicity to the bladder of CTX and RT, illustrating that the hemorrhagic cystitis can be extremely protracted lasting five years.

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Cyclophosphamide Hemorrhagic Cystitis

Cited by 30 publications

References 6 publications

Absence of prostacyclin greatly relieves cyclophosphamide‐induced cystitis and bladder pain in mice

Absence of prostacyclin greatly relieves cyclophosphamide‐induced cystitis and bladder pain in mice

Benign Diseases of the Bladder

Chronic hematuria and localized bladder damage following combined cyclophosphamide and local radiotherapy

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