Abstract | OBJECTIVE: To describe the incidence of, clinical manifestations of, and risk factors for cyclophosphamide-induced urinary bladder toxicity in patients treated for nonmalignant disease. DESIGN: SETTING: The Warren G. Magnuson Clinical Center of the National Institutes of Health (NIH). PATIENTS: MEASUREMENTS: Clinical characteristics, cystoscopic findings, results of cytologic examination of urine, surgical pathology, and total dose and duration of cyclophosphamide therapy were recorded and analyzed using a computer-based information retrieval system. RESULTS: Nonglomerular hematuria occurred in 73 of 145 patients treated with cyclophosphamide (50%). Sixty of the 73 patients with nonglomerular hematuria (82%) had cystoscopy at the NIH. Forty-two of the 60 patients (70%) who had cystoscopy had macroscopic changes consistent with cyclophosphamide-induced bladder injury. Seven patients (5%) developed transitional-cell carcinoma of the urinary bladder. In 6 of these 7 patients, the total cumulative cyclophosphamide dose exceeded 100 g, and the cumulative duration of cyclophosphamide therapy exceeded 2.7 years. Before they were given a diagnosis of bladder cancer, all 7 patients had had one or more episodes of microscopic or gross nonglomerular hematuria. In contrast, none of the 72 patients who had never had nonglomerular hematuria developed bladder cancer. Cox proportional hazards regression analysis showed that only microscopic nonglomerular hematuria was a significant risk factor for the development of bladder cancer (P < 0.01). CONCLUSION:
|
Authors | C Talar-Williams, Y M Hijazi, M M Walther, W M Linehan, C W Hallahan, I Lubensky, G S Kerr, G S Hoffman, A S Fauci, M C Sneller |
Journal | Annals of internal medicine
(Ann Intern Med)
Vol. 124
Issue 5
Pg. 477-84
(Mar 01 1996)
ISSN: 0003-4819 [Print] United States |
PMID | 8602705
(Publication Type: Journal Article)
|
Chemical References |
|
Topics |
- Aged
- Aged, 80 and over
- Carcinoma, Transitional Cell
(chemically induced)
- Cyclophosphamide
(adverse effects)
- Cystitis
(chemically induced)
- Female
- Granulomatosis with Polyangiitis
(drug therapy)
- Hematuria
(chemically induced)
- Humans
- Male
- Middle Aged
- Proportional Hazards Models
- Regression Analysis
- Retrospective Studies
- Risk Factors
- Urinary Bladder Neoplasms
(chemically induced)
- Urine
(cytology)
|