This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Martin, F. Articles by Houssiau, F.A. Search for Related Content PubMed PubMed Citation Articles by Martin, F. Articles by Houssiau, F.A. Pubmed/NCBI databases Compound via MeSH Substance via MeSH Medline Plus Health Information Autoimmune Diseases Vasculitis Hazardous Substances DB CYCLOPHOSPHAMIDE Social Bookmarking                   What's this?

Side-effects of intravenous cyclophosphamide pulse therapy

Rheumatology, Saint-Luc University Hospital, Louvain Medical School, Bruxelles, Belgium

B. Lauwerys

Rheumatology, Saint-Luc University Hospital, Louvain Medical School, Bruxelles, Belgium

C. Lefèbvre

General Internal Medicine Departments, Saint-Luc University Hospital, Louvain Medical School, Bruxelles, Belgium

J.-P. Devogelaer

Rheumatology, Saint-Luc University Hospital, Louvain Medical School, Bruxelles, Belgium

F.A. Houssiau

Rheumatology, Saint-Luc University Hospital, Louvain Medical School, Bruxelles, Belgium

We reviewed the side-effects of intravenous (IV) cyclophosphamide (CPM) pulse therapy in a group of 75 patients suffering from various autoimmune disorders (mostly systemic lupus erythematosus and vasculitis) who received a total of 451 IV CPM pulses, given on a monthly basis (mean ± s.d. CPM dose per pulse: 764 ± 217 mg; mean ± s.d. follow-up period: 26.7 ± 22.1 mon). Infection was the most common side-effect (30 episodes in 21 patients; 28% of the patients) but rarely required in-patient treatment (8 episodes in 7 patients; 9% of the patients). No relationship could be found between the occurrence of infection and the dose of CPM or of glucocorticoids. Other side-effects were rare. Only one patient suffered from neutropenia. Haemorragic cystitis was never observed nor did premature ovarian failure in the 25 female patients at risk. Four patients developed neoplasia and three died suddenly a few days after receiving a CPM pulse but the causal relationship between CPM therapy and these poor outcomes is speculative. Taken together, our data confirm in a large group of patients that IV CPM pulse therapy is relatively safe. In particular, the rate of severe infection requiring in-patient treatment is rare (1.8% of 451 pulses).

Key Words: cyclophosphamide • pulse • vasculitis • lupus • side-effects

Lupus, Vol. 6, No. 3, 254-257 (1997)
DOI: 10.1177/096120339700600307


CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				S Bernatsky, L Joseph, J-F Boivin, C Gordon, M Urowitz, D Gladman, P R Fortin, E Ginzler, S-C Bae, S Barr, et al. The relationship between cancer and medication exposures in systemic lupus erythaematosus: a case-cohort study Ann Rheum Dis, January 1, 2008; 67(1): 74 - 79. [Abstract] [Full Text] [PDF]

				G H Stummvoll, M Aringer, J S Smolen, S Schmaldienst, E Jimenez-Boj, W H Horl, W B Graninger, and K Derfler IgG immunoadsorption reduces systemic lupus erythematosus activity and proteinuria: a long term observational study Ann Rheum Dis, July 1, 2005; 64(7): 1015 - 1021. [Abstract] [Full Text] [PDF]

				P. Riley, S. M. Maillard, L. R. Wedderburn, P. Woo, K. J. Murray, and C. A. Pilkington Intravenous cyclophosphamide pulse therapy in juvenile dermatomyositis. A review of efficacy and safety Rheumatology, April 1, 2004; 43(4): 491 - 496. [Abstract] [Full Text] [PDF]

				A. F. Donia, S. H. Gazareen, H. A. Ahmed, F. E. Moustafa, A. A. Shoeib, A. M. Ismail, S. Khamis, and M. A. Sobh Pulse cyclophosphamide inadequately suppresses reoccurrence of minimal change nephrotic syndrome in corticoid-dependent children Nephrol. Dial. Transplant., October 1, 2003; 18(10): 2054 - 2058. [Abstract] [Full Text] [PDF]

				G. E. Katsifis, A. G. Tzioufas, P. G. Vlachoyiannopoulos, M. Voulgarelis, H. M. Moutsopoulos, and J. P. A. Ioannidis Risk of myelotoxicity with intravenous cyclophosphamide in patients with systemic lupus erythematosus Rheumatology, July 1, 2002; 41(7): 780 - 786. [Abstract] [Full Text] [PDF]

				A. Merico, G. Levedianos, P. Gallo, P. Zanco, F. Piccione, and P. Tonin Letter to the Editor Multiple Sclerosis, April 1, 2002; 8(2): 179 - 179. [PDF]

				S. Gulati, S. Pokhariyal, R. K. Sharma, R. Elhence, V. Kher, C. M. Pandey, and A. Gupta Pulse cyclophosphamide therapy in frequently relapsing nephrotic syndrome Nephrol. Dial. Transplant., October 1, 2001; 16(10): 2013 - 2017. [Abstract] [Full Text] [PDF]

				Z Blumenfeld, D Shapiro, M Shteinberg, I Avivi, and M Nahir Preservation of fertility and ovarian function and minimizing gonadotoxicity in young women with systemic lupus erythematosus treated by chemotherapy Lupus, July 1, 2000; 9(6): 401 - 405. [Abstract] [PDF]

				C A Slater, M H Liang, J W McCune, G M Christman, and M R Laufer Preserving ovarian function in patients receiving cyclophosphamide Lupus, January 1, 1999; 8(1): 3 - 10. [PDF]