Fox L P, Pandya A G
Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, USA.
Dermatol Clin. 2000 Jul;18(3):459-73. doi: 10.1016/s0733-8635(05)70194-7.
Cyclophosphamide is a potent immunosuppressive agent that has an important role in the treatment of autoimmune, neoplastic, granulomatous, and neutrophilic disorders. Pulse intravenous cyclophosphamide has been shown to be efficacious for several dermatologic disorders, particularly pemphigus vulgaris, with a low incidence of toxicity reported. As reported earlier, studies performed on the use of pulse intravenous cyclophosphamide in the treatment of a variety of dermatology-related diseases strongly suggest that the toxicities frequently noted with the use of oral cyclophosphamide therapy may be significantly less common with pulse intravenous administration of cyclophosphamide. The short follow-up period of patients treated with this modality so far, however, requires constant vigilance for the development of side effects, particularly secondary malignancy. At this time, pulse intravenous cyclophosphamide is a promising treatment modality with an acceptable risk profile for moderate-to-severe dermatologic diseases recalcitrant to standard therapy. Prospective comparative trials are needed to assess further the efficacy and toxicity of this therapy.
环磷酰胺是一种强效免疫抑制剂，在自身免疫性、肿瘤性、肉芽肿性和嗜中性粒细胞疾病的治疗中具有重要作用。静脉冲击环磷酰胺已被证明对几种皮肤病有效，尤其是寻常型天疱疮，且报道的毒性发生率较低。如先前报道，对静脉冲击环磷酰胺治疗各种皮肤病相关疾病的研究强烈表明，与口服环磷酰胺治疗相比，静脉冲击环磷酰胺使用时常见的毒性可能明显少见。然而，到目前为止，接受这种治疗方式的患者随访期较短，需要持续警惕副作用的发生，尤其是继发性恶性肿瘤。目前，静脉冲击环磷酰胺是一种有前景的治疗方式，对于对标准治疗耐药的中重度皮肤病具有可接受的风险状况。需要进行前瞻性对照试验以进一步评估这种治疗的疗效和毒性。
