Busulfan hemorrhagic cystitis with

Mechlorethamine Forms DNA cross-links, resulting in inhibition of DNA synthesis and function Hodgkin s and non-Hodgkin s lymphoma Nausea and vomiting Moderate depression of peripheral blood count excessive doses produce severe bone marrow depression with leukopenia, thrombocytopenia, and bleeding alopecia and hemorrhagic cystitis occasionally occur with cyclophosphamide cystitis can be prevented with adequate hydration busulfan is associated with skin pigmentation, pulmonary fibrosis, and adrenal... 

Like cyclophosphamide, ifosfamide causes a hemorrhagic cystitis in a high proportion of patients, with an occasionally fatal outcome. The damage to urinary bladder epithelium is caused by acrolein, a metabolite that is excreted in the urine. In bone marrow transplant recipients, prior administration of busulfan, which itself causes hemorrhagic cystitis, can increase this risk of oxazaphosphorines (12). Mesna (sodium... 

The toxic effects of busulfan are related to its myelosuppressive properties prolonged thrombocytopenia may occur. Occasional patients experience nausea, vomiting, and diarrhea. Longterm use leads to impotence, sterility, amenorrhea, and fetal malformation. Rarely, patients develop asthenia and hypotension. High-dose busulfan causes VOD of the liver in up to 10% of patients, as well as seizures, hemorrhagic cystitis, alopecia, and cataracts. The coincidence of VOD and hepatotoxicity is increased by its coadministration with drugs that inhibit CYPs, including imidazoles and metronidazole, possibly by inhibition of the clearance of busulfan and/or its toxic metabolites. 

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