Adriamycin enhancement of cyclophosphamide-induced bladder injury

Hemorrhagic cystitis as a complication of cancer chemotherapy has been most commonly associated with cyclophosphamide. We report on a patient who had received cyclophosphamide for treatment of breast carcinoma and had hemorrhagic cystitis temporally associated with subsequent adriamycin therapy. The development of subclinical bladder injury induced by cyclophosphamide and enhanced by adriamycin similar to their combined toxicities at other sites (skin, esophagus and heart) is postulated.