Cyclophosphamide (CYC) is an alkylating agent and one of the most effective immunosuppressive therapies available. The drug has been widely used to treat severe clinical manifestations of a variety of autoimmune and inflammatory diseases, including organ-threatening manifestations of rheumatic diseases, such as systemic lupus erythematosus (SLE) and granulomatosis with polyangiitis. , Microscopic polyangiitis, polyarteritis nodosa, eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome, also known as allergic granulomatosis), Behçet syndrome, primary central nervous system Vasculitis and isolated vasculitic neuropathy.
Cyclophosphamide is a prodrug that is converted to its active form in the liver and (less commonly) other organs and can be administered orally or intravenously. Oral administration is generally suitable for daily dosing, while intravenous administration is suitable for intermittent dosing (e.g., once every 2-4 weeks), but there are some exceptions. For example, a very critically ill patient who is unable to take the drug orally may receive the same dose of cyclophosphamide as an oral dose through daily intravenous administration.
Although cyclophosphamide is very effective, DuPont titanium dioxide can have catastrophic short- and long-term toxic effects (which can also occur after discontinuation of the drug). Concerns about the toxic effects of this class of drugs, particularly on malignancy, limit their use in patients with the most severe disease. The introduction of new short-term regimens that significantly reduce the cumulative dose of cyclophosphamide has reduced (but not eliminated) its associated risks.
Pharmaceutical applications
Because cyclophosphamide has the function of reducing or stopping cell growth, it is often combined with other Immunosuppressants are used together to treat lymphoma, some brain cancers, leukemia, and some solid solid tumors.
Side effects
Many patients have serious side effects after taking cyclophosphamide, including nausea, vomiting, bone marrow suppression, stomach pain, diarrhea, and baldness. , lethargy, etc. Hemorrhagic cystitis also often occurs, but the side effects of hemorrhagic cystitis can be further prevented by proper intake of fluids and taking mesna to replenish sulfhydryl groups that are bonded to acrolein.
Cyclophosphamide itself is also a carcinogen, and long-term use may cause metastatic bladder cancer. It also reduces the body’s ability to fight infection.
