Incidence of hemorrhagic cystitis after cyclophosphamide therapy with or without mesna: A cohort study and comprehensive literature review.
Haya M AlmalaqSarah S AlasmariMounerah H AlrayesMunirah A BinhameedReem A AlsudairiMaha M AlosaimiGhada A AlnasserRawan A AbuzaidNajma KhalilHanan H AbouzaidAbdulrahman S AlarfajPublished in: Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners (2020)
A total of 718 patients' medical records were reviewed. The majority of the patients received mesna (n = 433, 60%). The mesna group had a greater incidence of hemorrhagic cystitis (3.5% vs. 0.4%, p < 0.004) and received a significantly larger cumulative dose (3103 ± 1696 vs. 2465 ± 1528, p < 0.001) mg of cyclophosphamide therapy. Our literature review revealed large differences in the conclusions of published trials with highly diverse study designs and populations, emphasizing on the need of large prospective trials to address this topic.Conclusion and relevance: Our study results do not support the use of mesna in preventing hemorrhagic cystitis. We found that the only influential factor in the development of hemorrhagic cystitis was the dose of cyclophosphamide therapy.