Treatment of Cyclophosphamide-Induced Cystitis with Prostaglandin E₂

Excerpt

To the editor: High-dose cyclophosphamide chemotherapy can be complicated by haemorrhagic cystitis, probably due to the effect of acrolein, a breakdown product, on the urothelium. The cystitis is occasionally fatal (1). The concurrent use of mesna (sodium 2-mercaptoethanesulphonate) has decreased the incidence of this complication (2). We report here the successful use of topical prostaglandin E₂ (dinoprostone) in controlling severe chronic haemorrhagic cystitis after cyclophosphamide therapy to condition a bone marrow transplant recipient.

An 18-year-old Iranian man had bone marrow transplantation for acute myeloid leukaemia during a refractory central nervous system relapse. On the fourth and third days before transplantation,