Department of Medicine, Division of Hematology/Oncology, University of Pennsylvania Health System, Philadelphia, PA 19104, USA.
Breast J. 2012 May-Jun;18(3):272-5. doi: 10.1111/j.1524-4741.2011.01161.x. Epub 2011 Oct 5.
Hemorrhagic cystitis is a known complication of high-dose cyclophosphamide treatment, generally occurring at doses greater than 100 g. There are few reports of hemorrhagic cystitis occurring with low-dose cyclophosphamide therapy, and this complication has not been described in breast cancer patients. We present a case of a patient with stage IIB breast cancer who developed clinical, radiographic, and pathologic evidence of hemorrhagic cystitis after a single 600 mg/m(2) dose of cyclophosphamide. Three subsequent cycles of cyclophosphamide with the addition of IV hydration and MESNA were given without complication, and the patient's urologic symptoms resolved. Repeat cystoscopy demonstrated pathologic resolution of the cystitis. We review the literature regarding proposed mechanisms of hemorrhagic cystitis, and discuss the applicability of these hypotheses in our patient.
出血性膀胱炎是大剂量环磷酰胺治疗的已知并发症，通常发生在剂量大于 100g 时。低剂量环磷酰胺治疗时很少发生出血性膀胱炎的报道，并且在乳腺癌患者中尚未描述该并发症。我们报告了一例 IIB 期乳腺癌患者，在单次 600mg/m(2)环磷酰胺剂量后出现临床、影像学和病理证据的出血性膀胱炎。随后给予了 3 个周期的环磷酰胺治疗，同时给予 IV 水化和 MESNA，没有出现并发症，患者的泌尿系统症状得到缓解。重复膀胱镜检查显示膀胱炎的病理缓解。我们回顾了关于出血性膀胱炎发病机制的文献，并讨论了这些假说在我们患者中的适用性。
