Hemorrhagic cystitis in children treated with alkylating agent cyclophosphamide: The experience of a medical center in Taiwan
Journal
Journal of the Formosan Medical Association
Journal Volume
114
Journal Issue
8
Pages
691-697
Date Issued
2015
Author(s)
Abstract
Background/Purpose: Hemorrhagic cystitis is a common complication with chemotherapeutic alkylating agents. We investigated the possible prognostic factors of cyclophosphamide-induced hemorrhagic cystitis in children. Methods: Medical records of children (< 18 years old) with cyclophosphamide-related hemorrhagic cystitis were collected retrospectively from January 2000 to December 2010 in a tertiary care center. We also prospectively enrolled children (< 18 years old) with cyclophosphamide treatment. Results: The retrospective study consisted of 23 patients whose median age was 11 years. The median day of onset time was 1 day after cyclophosphamide usage. The hemato-oncological diseases included acute leukemia (39.1%), lymphoma (13%), blastoma (13%), sarcoma (13%), aplastic anemia (13%), and others (8.7%). Patients who received bone marrow transplantation (BMT) had significantly longer duration of hemorrhagic cystitis than those who did not receive BMT (p < 0.05). Serum uric acid, checked prior to and after the onset of hemorrhage cystitis, was significantly lower after the development of hemorrhagic cystitis (p < 0.05). In the prospective study, 11 children were enrolled with a median age of 5 years. The urinary nitrite/nitrate and 8-iso-prostaglandin F2α levels increased significantly after cyclophosphamide usage (p < 0.05). Conclusion: Alteration serum uric acid level and BMT could be indicators for severe hemorrhagic cystitis. The elevated levels of urinary nitrite/nitrate and 8-iso-prostaglandin F2α may indicate the essential roles played by nitric oxide syntheses and reactive oxidative stress in cyclophosphamide-induced hemorrhagic cystitis. These findings may help clinicians formulate a better strategy for treating cyclophosphamide-induced hemorrhagic cystitis. ? 2013.
SDGs
Other Subjects
cyclophosphamide; nitrate; nitrite; uric acid; alkylating agent; cyclophosphamide; uric acid; acute leukemia; adolescent; aplastic anemia; Article; blastoma; bone marrow transplantation; child; clinical article; cyclophosphamide-induced cystitis; disease duration; drug use; female; human; lymphoma; male; preschool child; prognostic assessment; prospective study; retrospective study; sarcoma; school child; Taiwan; tertiary care center; uric acid blood level; adverse effects; bladder; bleeding; blood; chemically induced; cystitis; drug effects; pilot study; Adolescent; Antineoplastic Agents, Alkylating; Bone Marrow Transplantation; Child; Child, Preschool; Cyclophosphamide; Cystitis; Female; Hemorrhage; Humans; Male; Pilot Projects; Prospective Studies; Retrospective Studies; Taiwan; Tertiary Care Centers; Uric Acid; Urinary Bladder
Type
journal article