Cyclophosphamide in the treatment of common neoplastic diseases of childhood

The Clinical and Cellular Pharmacology Of Vincristine, Corticosteroids, l‐Asparaginase, Anthracyclines and Cyclophosphamide In Relation To Childhood Acute Lymphoblastic Leukaemia

“…Single‐agent studies were reported in the early 1960s. For dosing schedules that included CP at a dose of 150–200 mg/kg/d intravenously for up to 14 d (Sweeney et al , 1962) and 2–7·5 mg/kg/d orally as a maintenance dose after intravenous priming (Fernbach et al , 1962), response rates of 30–40% (10–20% complete remission) were found for children with relapsed ALL.…”

Cyclophosphamide Necrosis of Bladder Causing Calcification, Contracture and Reflux; Treated by Colocystoplasty

“…of patients treated with cyclophosphamide (Bethel1 et Host and Nissen-Meyer, 1960;Stoll and Matar, 1961;Sweeney et af., 1962;Sullivan, 1965;Reynolds et al, 1969). It usually follows high dosage, intermittent intravenous therapy when it may appear after the first dose (Host and Nissen-Meyer, 1960;Sullivan, 1965); but with oral therapy it may not occur for several years, and after over 100 g. of the drug have been given. It may first be seen or may relapse several weeks after the cyclophosphamide has been discontinued (George, 1963 ;Spiers, 1963 ;Pearlman, 1966).…”

“…The cystitis usually resolves but repeated urinary infection, bladder neck obstruction (Sullivan, 1965) and haematuria so severe as to need massive blood transfusion (George, 1963;Anderson et al, 1967;Riggenbach et al, 1968;Reynolds et al, 1969) may result. The epithelial proliferation may simulate infiltrating carcinoma or Hodgkin's disease (Pearlman, 1966).…”

“…Bladder obtained by biopsy or at autopsy has shown ulceration, increased vascularity, and fibrosis of subepithelial layers (George, 1963;Sullivan, 1965;Pearlman, 1966;Rubin and Rubin, 1966;Anderson et al, 1967;Reynolds et al, 1969). In none of these, nor in any other clinical report, has calcification been noted.…”

“…CYCLOPHOSPHAMIDE was developed by Arnold and Bourseaux in I957 and was soon reported to cause a sterile hzmorrhagic cystitis (Coggins et al, 1959). At first this was considered a mild condition, but later reports stressed its severity, persistence and secondary complications (George, 1963;Spiers, 1963;Sullivan, 1965;Pearlman, 1966;Rubin and Rubin, 1966;Anderson et al, 1967;Fernbach, 1967;Riggenbach et al, 1968;Reynolds et al, 1969). Sloughing of the bladder wall followed by epithelial regeneration, vesico-ureteric reflux and calcification in the bladder wall has not previously been described.…”