Effects of cyclophosphamide on the development of malignancy and on long‐term survival of patients with rheumatoid arthritis a 20‐year followup study

Abstract

Objective. To examine the effects of cyclophosphamide (CYC) on the development of malignancies and on the long-term survival of patients with rheumatoid arthritis (RA).Methods. We used a longitudinal cohort design in which 119 patients (76 women and 43 men) with refractory RA who were treated with oral CYC between 1968 and 1973 were compared with 119 control patients with RA (matched for age, sex, disease duration, and functional class) who were evaluated during the same time period but did not receive CYC.Results. There was increased risk of malignancy in the CYC-treated group, with 50 cancers found in 37 patients in the CYC group compared with 26 cancers in 25 of the control patients (P < 0.05). The relative risk of cancer for those treated with CYC was 1.5 (95% confi-

Mycophenolate Mofetil versus Azathioprine in the Maintenance Therapy of Lupus Nephritis

“…damage, [16][17][18] and malignancy. [19] Many patients (up to 22%) fail to achieve remission with this regimen or relapse after treatment, and some patients still progress to endstage renal disease. [20] The aim of the present study was to demonstrate the efficacy of mycophenolate mofetil (MMF) versus azathioprine (AZA) as a maintenance therapy for lupus nephritis.…”

Malignancy in scleroderma patients from south west England: a population-based cohort study

“…Cyclophosphamide has been linked with a 30-fold increase in risk of bladder cancers, and an overall two to four-fold increase in haematological and skin malignancies. [17] Occasionally, malignancy may indirectly induce scleroderma as part of a paraneoplastic process. This has been observed in malignant carcinoid syndrome and also in POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, skin changes), which most commonly occurs in patients with IgA plasmacytoma.…”

Long-term Risk of Malignancy Among Patients Treated With Immunosuppressive Agents for Ocular Inflammation: A Critical Assessment of the Evidence

“…25 An increased risk of malignancy with cyclophosphamide therapy may not be evident until four or more years following treatment. 17,19,26 One study projected that the risk of bladder cancer was 5% at 10 years and 16% at 15 years. 27 Several studies remark on an increased risk of bladder cancer among smokers, suggesting risk may be especially high in this group of patients.…”