Incidence of cyclophosphamide-induced hemorrhagic cystitis in Chinese Han population with autoimmune disease

Cyclophosphamide (CTX), has been widely used for treating various human malignancies as well as autoimmune disease. Although CTX could rapidly decrease the response of immune system, it also could result in severe adverse effects, such as hemorrhagic cystitis (HC). In this study, we investigated the occurrence of HC in patients taking CTX from Chinese Han population and divided all cases into different groups according to the methods of CTX administration. In all cases involved in our study, macroscopic hematuria caused by the primary diseases was observed in 316 patients (47%) before the initiation of CTX treatment and the symptom in these patients gradually disappeared during follow-up examination, indicating the hematuria was unrelated with CTX-induced HC. Moreover, there were 5 macroscopic hematuria cases and 17 macroscopic hematuria cases were classified as urinary tract infection and can be treated by antibiotics. Only one female patient had been suspected as HC case but the symptom disappeared after switching CTX to mycophenolate mofetil. In conclusion, our data suggested the Chinese Han population may be highly resistant for CTX induced hemorrhagic cystitis.