[Effective clinical use of cyclophosphamide in hematological malignancies]

Cyclophosphamide (CPA) is the most widely used alkylating agent in the treatment of hematological malignancies. We review current clinical potential of high-dose CPA administration in this field. The efficacy of dose intensification of CPA in CHOP regimen for patients with aggressive lymphoma is being investigated in some clinical trials. High-dose CPA administration and G-CSF infusion effectively mobilize high levels of peripheral blood stem cell suitable for autografting. High-dose regimens of CPA alone or in combination with other agents also have been used to treat various hematological malignancies in conjunction with stem cell transplantation (SCT). A variety of adverse effects have been observed with the high-dose CPA used in preparative regimens for SCT. Hemorrhagic cystitis and cardiac toxicity are common and dose-limiting toxic effect of high-dose CPA administration.