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Severe cyclophosphamide-induced haemorrhagic cystitis treated with hyperbaric oxygen
Michael Davis1, Heather MacDonald, Christopher Sames
1Hyperbaric Medicine Unit, Christchurch Hospital, Private Bag 4710, Christchurch, New Zealand. mike.davis@cdhb.govt.nz
The New Zealand Medical Journal
|September 29, 2011
Summary
Hyperbaric oxygen therapy (HBOT) effectively treated severe cyclophosphamide-induced haemorrhagic cystitis (CHC). All six patients experienced cessation of bleeding and remained symptom-free during long-term follow-up.
Area of Science:
- Urology
- Oncology
- Hyperbaric Medicine
Background:
- Cyclophosphamide-induced haemorrhagic cystitis (CHC) is a serious complication caused by the urotoxic metabolite acrolein.
- Hyperbaric oxygen therapy (HBOT) is proposed for CHC due to its benefits in hypoxic tissue repair, similar to radiation cystitis.
- HBOT enhances neutrophil function, fibroblast migration, and angiogenesis, promoting healing in damaged tissues.
Purpose of the Study:
- To review the New Zealand experience with hyperbaric oxygen therapy (HBOT) for cyclophosphamide-induced haemorrhagic cystitis (CHC).
- To evaluate the efficacy and safety of HBOT in managing intractable CHC.
Main Methods:
- Retrospective review of case records for patients with CHC treated with HBOT.
- Data collected from three New Zealand hyperbaric medicine units between 2000 and 2007.
Main Results:
- Six patients with life-threatening CHC hemorrhage were identified.
- All six patients achieved cessation of bleeding after 14 to 40 HBOT sessions.
- No complications were reported, and all patients remained free of hematuria at 11 to 36 months follow-up.
Conclusions:
- Hyperbaric oxygen therapy (HBOT) is recommended for intractable cyclophosphamide-induced haemorrhagic cystitis (CHC).
- HBOT is an effective and low-risk treatment option for severe CHC.
