Cyclophosphamide leukemia

O Brien S, Moore JO, Boyd TE et al (2007) Randomized phase III trial of fludarabine plus cyclophosphamide with or without oblimersen sodium (Bcl-2 antisense) in patients with relapsed or refractory chronic lymphocytic leukemia. J Clin Oncol 25(9) 1114-1120... 

Alkylating agents Cyclophosphamide Myelosuppression, hemorrhagic cystitis Alopecia, stomatitis, amenorrhea, aspermia, secondary leukemias... 

C, cytarabine ASP, asparaginase CALCB, Cancer and Leukemia Croup B CNS, central nervous system CTX, cyclophosphamide DEX, dexamethasone DNR, daunorubicin DOX, doxorubicin IT, intrathecal captopurine MTX, methotrexate PRED, prednisone TG, thioguanine VCR, vincristine. 

Tsukamoto N, Chen J, Yoshida A. Enhanced expressions of glucose-6-phos-phate dehydrogenase and cytosolic aldehyde dehydrogenase and elevation of reduced glutathione level in cyclophosphamide-resistant human leukemia cells. Blood Cells Mol Dis 1998 24 231-238. 

The answer is c. (Hardman, pp 1238-1239.) Remission maintenance can be carried out by combination therapy, which includes cyclophosphamide. Cyclophosphamide causes hemorrhagic cystitis. Doxorubicin and carmustine are useful in the treatment of acute lymphatic leukemia, but neither is known to cause hemorrhagic cystitis. 

Novel nitroxide malonate methanofullerenes (Fig. 1.3), thanks to the presence of nitroxide radicals and fullerene moiety, are able to protect cells from toxic side effects of cyclophosphamide (Gubskaya et al., 2007). Experiments were carried out on mice, in which leukemia P-388 was transplanted. Cyclophosphamide or fullerene individually injected did not increase the average life span of the animals, while the combination of the anticancer drug and nitroxide fullerene derivative resulted in the survival of 70% animals, classifying these compounds as promising modifiers of biological reaction for tumor therapy. 

The alkylating agents can be considered to be cell-cycle independent drugs. They are used for the management of leukemias, lymphomas, multiple myeloma and some carcinoma s and soft tissue tumors, generally as components of drug combination regimens. Cyclophosphamide is also used for its marked immunosuppressant properties. 

Ifosfamide is less myelosuppressive than cyclophosphamide but is more toxic to the bladder. It also may produce alopecia, nausea, vomiting, infertility, and second tumors, particularly acute leukemias. Neurological symptoms including confusion, somnolence, and hallucinations have also been reported. It is recommended... 

Although this has been shown to occur in experimental animals after exposure of males to foreign compounds such as cyclophosphamide, there is only inconclusive evidence that this occurs in humans. Thus, studies of exposure of human males to vinyl chloride, dibromo-chloropropane, and anesthetic gases, for example, have revealed only equivocal evidence of developmental toxicity in the offspring. There now seems to be some evidence that the leukemia occurring in children, which appears to be clustered around nuclear fuel-reprocessing plants such as Sellafield in the United Kingdom, may be due to paternal exposure to radiation. 

Brochstein JA, Keman NA, Groshen S, Cirricione C, et al. 1987. Allogenic bone marrow transplantation after hyperfractionated total body irradiation and cyclophosphamide in children with acute leukemia. NEJM. 317 1618-1624. 

Ferry C, Socie G. 2003. Busulfan-cyclophosphamide versus total body irradiation-cyclophosphamide as preparative regimen before allogeneic hematopoietic stem cell transplantation for acute myeloid leukemia What have we learned Exp Hematol. 31 1182-1186. 

Socie G, Clift RA, Blaise D, Devergie A, et al. 2001. Busulfan plus cyclophosphamide compared with total-body irradiation plus cyclophosphamide before marrow transplantation for myeloid leukemia Long term followup of four randomized studies. Blood. 98 3569-3574. 

Cyclophosphamide Cytoxan, Neosar Acute and chronic lymphocytic leukemia acute and chronic myelocytic leukemia carcinoma of ovary, breast Hodgkin disease non-Hodgkin lymphomas multiple myeloma Blood disorders (anemia, leukopenia, thrombocytopenia] Gl distress (nausea, vomiting, loss of appetite] bladder irritation hair loss car-diotoxicity pulmonary toxicity... 

Cyclophosphamide (Cytoxan and Endoxan) is used in the treatment of Hodgkin s disease, lymphosarcoma, and other lymphomas. It is employed as a secondary drug in patients with acute leukemia and in combination with doxorubicin in women with breast cancer. A drug combination effective in the treatment of breast cancer is cyclophosphamide, methotrexate, fluorouracil, and prednisone (CMFP). Cyclophosphamide is also an immunosuppressive agent. The toxicity of cyclophosphamide causes alopecia, bone marrow depression, nausea and vomiting, and hemorrhagic cystitis. 

Enhanced effect of cyclophosphamide against Lewis lung carcinoma and LI210 leukemia (mice) 496... 

Thalicarpine Synergistic with cyclophosphamide against LI210 leukemia in mice but in combination with BCNU gave reduced longevity 643... 

In mice, effective in combination with cyclophosphamide against thalicarpine-resistant lymphoid leukemia LI210 646... 

Acute lymphocytic leukemia Induction vincristine plus prednisone. Remission maintenance mercaptopurine, methotrexate, and cyclophosphamide in various combinations Asparaginase, daunorubicin, carmustine, doxorubicin, cytarabine, allopurinol,1 craniospinal radiotherapy... 

Total body irradiation, a routine preconditioning procedure for treatment of leukemia and aplastic anemia before bone marrow transplantation, decreased TAC of blood plasma by 36%, as estimated by cyclic voltammetry (C26). TAC was found to decrease by about 40% during chemotherapy of patients with various hematologic malignancies with busuflan, VP-16, and cyclophosphamide (D12). The controversial procedure of blood ozonation was reported to decrease blood plasma TAC by 20% (B17). Treatment of hypercholesterolemic patients with bezafibrate (600 mg/day) for 1 month decreased TAC of their blood serum (G16). Propofol anesthesia decreased TAC of blood plasma of patients by 9.5% this effect was caused by hemodilution because mean hemoglobin concentration of the blood decreased accordingly (S26). 

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