Incidence of Cyclophosphamide-induced Urotoxicity and Protective Effect of Mesna in Rheumatic Diseasesle

Neslihan Yilmaz; Hakan Emmungil; Sercan Gucenmez; Gulsen Ozen; Fatih Yildiz; Ayse Balkarli; Gezmis Kimyon; Belkis Nihan Coskun; Ismail Dogan; Omer Nuri Pamuk; Sule Yasar; Gozde Yildirim Cetin; Ayten Yazici; Serpil Ergulu Esmen; Yonca Cagatay; Sema Yilmaz; Ayse Cefle; Mehmet Sayarlioglu; Timucin Kasifoglu; Omer Karadag; Yavuz Pehlivan; Ediz Dalkilic; Bunyamin Kisacik; Veli Cobankara; Eren Erken; Haner Direskeneli; Kenan Aksu; Sule Yavuz

doi:10.3899/jrheum.150065

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Incidence of Cyclophosphamide-induced Urotoxicity and Protective Effect of Mesna in Rheumatic Diseasesle

Journal article

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Incidence of Cyclophosphamide-induced Urotoxicity and Protective Effect of Mesna in Rheumatic Diseasesle

Neslihan Yilmaz, Hakan Emmungil, Sercan Gucenmez, Gulsen Ozen, Fatih Yildiz, Ayse Balkarli, Gezmis Kimyon, Belkis Nihan Coskun, Ismail Dogan, Omer Nuri Pamuk, …

Journal of rheumatology, Vol.42(9), pp.1661-1666

09/01/2015

DOI: 10.3899/jrheum.150065

PMID: 26178288

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Abstract

Objective. To assess bladder toxicity of cyclophosphamide (CYC) and uroprotective effect of mesna in rheumatic diseases. Methods. Data of 1018 patients (725 women/293 men) treated with CYC were evaluated in this retrospective study. All of the following information was obtained: the cumulative CYC dose, route of CYC administration, duration of therapy, concomitant mesna usage, and hemorrhagic cystitis. Cox proportional hazard model was used for statistics. Results. We identified 17 patients (1.67%) with hemorrhagic cystitis and 2 patients (0.19%) with bladder cancer in 4224 patient-years. The median time for diagnosis to hemorrhagic cystitis was 10 months (4-48) and bladder cancer was 8 years (6-10.9). There were 583 patients (57.2%) who received mesna with intravenous CYC therapy. We observed similar incidence rate for hemorrhagic cystitis in both patient groups concomitantly treated with or without mesna [9/583 (1.5%) vs 8/425 (1.8%) respectively, p = 0.08]. Cumulative CYC dose (HR for 10-g increments 1.24, p < 0.001) was associated with hemorrhagic cystitis. Conclusion. Cumulative dose was the only risk factor for hemorrhagic cystitis in patients treated with CYC. No proof was obtained for the uroprotective effect of mesna in our cohort.

Rheumatology

Life Sciences & Biomedicine

Science & Technology

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Title: Subtitle: Incidence of Cyclophosphamide-induced Urotoxicity and Protective Effect of Mesna in Rheumatic Diseasesle
Creators: Neslihan Yilmaz - Istanbul Bilim University
Hakan Emmungil - Ege University
Sercan Gucenmez - Ege University
Gulsen Ozen - Marmara University
Fatih Yildiz - Cukurova University
Ayse Balkarli - Pamukkale University
Gezmis Kimyon - Gaziantep Rheumatol Univ, Fac Med, Gaziantep, Turkey
Belkis Nihan Coskun - Uludag Univ, Dept Rheumatol, Fac Med, Bursa, Turkey
Ismail Dogan - Hacettepe University
Omer Nuri Pamuk - Trakya University
Sule Yasar - Eskişehir Osmangazi University
Gozde Yildirim Cetin - Ege University
Ayten Yazici - Kocaeli Univ, Fac Med, Dept Rheumatol, Izmit, Turkey
Serpil Ergulu Esmen - Selçuk University
Yonca Cagatay - Istanbul Bilim University
Sema Yilmaz - Selçuk University
Ayse Cefle - Kocaeli Univ, Fac Med, Dept Rheumatol, Izmit, Turkey
Mehmet Sayarlioglu - Kahramanmaraş Sütçü İmam University
Timucin Kasifoglu - Eskişehir Osmangazi University
Omer Karadag - Hacettepe University
Yavuz Pehlivan - Uludag Univ, Dept Rheumatol, Fac Med, Bursa, Turkey
Ediz Dalkilic - Uludag Univ, Dept Rheumatol, Fac Med, Bursa, Turkey
Bunyamin Kisacik - Gaziantep Rheumatol Univ, Fac Med, Gaziantep, Turkey
Veli Cobankara
Eren Erken
Haner Direskeneli
Kenan Aksu
Sule Yavuz
Resource Type: Journal article
Publication Details: Journal of rheumatology, Vol.42(9), pp.1661-1666
DOI: 10.3899/jrheum.150065
PMID: 26178288
NLM abbreviation: J Rheumatol
ISSN: 0315-162X
eISSN: 1499-2752
Publisher: J Rheumatol Publ Co
Number of pages: 6
Language: English
Date published: 09/01/2015
Academic Unit: Internal Medicine
Record Identifier: 9984702822302771

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