USMLE

Cyclophosphamide

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Anti-Neoplastic Drugs
  1. Cyclophosphamide
  2. Methotrexate
  3. Tamoxifen
  4. Cisplatin
  5. Doxorubicin
  6. Imatinib
  7. Paclitaxel
  8. Rituximab
  9. Trastuzumab
  10. Vincristine

Summary

Cyclophosphamide and ifosfamide are chemotherapy drugs that can treat a wide variety of cancers. They also have anti-inflammatory properties that are used to treat autoimmune conditions like lupus and myasthenia gravis. An important side effect of these drugs is hemorrhagic cystitis, or bladder damage causing bleeding into the urine. It also causes the side effects common to most chemotherapy drugs - bone marrow suppression and GI upset.

Key Points

  • Cyclophosphamide, Ifosfamide
    • Mechanism
      • Alkylating agent
        • Inhibits protein synthesis by interfering with DNA replication
        • Inhibits activation of T-lymphocytes
    • Clinical Use
      • Cancer / Antineoplastic
        • Leukemias
        • Lymphomas
        • Multiple myeloma
        • Breast and ovarian cancer
        • Lung cancer
        • Retinoblastoma
      • Autoimmune Diseases / Anti-inflammatory
        • Polyarteritis nodosa
        • Lupus nephritis
          • A form of lupus that involves deterioration of the kidneys
        • Myasthenia gravis
    • Side Effects and Adverse Reactions
      • Hemorrhagic cystitis
        • Bladder inflammation & blood in urine
        • Common complication, usually not life-threatening
        • Treated by increasing hydration
      • Common chemotherapy side effects
        • Bone marrow suppression
          • Common side effect of many chemotherapeutic drugs due to damage of rapidly-dividing blood cell progenitors
          • Leads to anemia (low red blood cells)
            • Fatigue, dyspnea, pallor
          • Leads to leukopenia (low white blood cells)
            • Increased risk for infection
          • Leads to thrombocytopenia (low platelets)
            • Petechiae, purpura, bleeding
        • GI disturbances
          • Nausea, vomiting, anorexia, diarrhea
          • Common side effect of many chemotherapeutic drugs due to damage of rapidly-dividing gut wall
          • An antiemetic may be ordered prior to chemotherapy
        • Alopecia (hair loss)