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Ifosfamide-Induced Malignancy of Ureter and Bladder
Aparna Sannu1, Resmi Radha2, Anitha Mathews3
1Department of Radiation Oncology, Regional Cancer Centre Trivandrum.
Cureus
|October 25, 2017
Summary
Ifosfamide may cause bladder cancer, similar to cyclophosphamide. This case report highlights the risk, suggesting careful dosing and monitoring for patients undergoing ifosfamide therapy.
Area of Science:
- Oncology
- Urology
- Toxicology
Background:
- Cyclophosphamide is known to induce bladder malignancies via its metabolite, acrolein.
- Hemorrhagic cystitis during chemotherapy is linked to subsequent cancer development.
Observation:
- A case of multifocal urothelial carcinoma developed 19 years after ifosfamide treatment.
- This is the first reported case of ifosfamide-induced malignancy in the literature.
Findings:
- Ifosfamide, like cyclophosphamide, poses a risk for bladder toxicity and potential malignancy.
- The study reviews ifosfamide's bladder toxicity mechanisms and associated risks.
Implications:
- Minimize ifosfamide dosage and monitor patients receiving >20g for microscopic hematuria.
- Prophylactic measures like hydration, frequent voiding, daytime administration, and mesna may reduce bladder urothelium exposure to toxic metabolites.
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