{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T21:40:39Z","timestamp":1792014039475,"version":"4.4.0"},"reference-count":35,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2020,5,1]],"date-time":"2020-05-01T00:00:00Z","timestamp":1588291200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Oncol Pharm Pract"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cyclophosphamide is an alkylating agent associated with significant toxicities, most importantly hemorrhagic cystitis. Many approaches including mesna use were established to reduce this toxicity. However, data on mesna efficacy are conflicting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the incidence of hemorrhagic cystitis in patients receiving cyclophosphamide therapy with or without mesna.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective chart review was done on all adult patients receiving cyclophosphamide therapy with or without mesna at the King Saud University Medical City. The incidence of hemorrhagic cystitis was recorded. Patients receiving mesna were compared with those not receiving mesna. Data were reported as numbers and percentages, and appropriate statistical tests of association were used. This step was followed by a comprehensive literature review using appropriate keywords in PubMed from the inception of the database until August 2019. All studies of interest were reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 718 patients\u2019 medical records were reviewed. The majority of the patients received mesna (n\u2009=\u2009433, 60%). The mesna group had a greater incidence of hemorrhagic cystitis (3.5% vs. 0.4%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.004) and received a significantly larger cumulative dose (3103\u2009\u00b1\u20091696 vs. 2465\u2009\u00b1\u20091528,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) mg of cyclophosphamide therapy. Our literature review revealed large differences in the conclusions of published trials with highly diverse study designs and populations, emphasizing on the need of large prospective trials to address this topic.\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>Conclusion and relevance:<\/jats:bold>\n                      Our study results do not support the use of mesna in preventing hemorrhagic cystitis. We found that the only influential factor in the development of hemorrhagic cystitis was the dose of cyclophosphamide therapy.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1078155220920690","type":"journal-article","created":{"date-parts":[[2020,5,1]],"date-time":"2020-05-01T08:55:01Z","timestamp":1588323301000},"page":"340-349","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":29,"title":["Incidence of hemorrhagic cystitis after cyclophosphamide therapy with or without mesna: A cohort study and comprehensive literature review"],"prefix":"10.1177","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8531-556X","authenticated-orcid":false,"given":"Haya M","family":"Almalag","sequence":"first","affiliation":[{"name":"Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah S","family":"Alasmari","sequence":"additional","affiliation":[{"name":"Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mounerah H","family":"Alrayes","sequence":"additional","affiliation":[{"name":"Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Munirah A","family":"Binhameed","sequence":"additional","affiliation":[{"name":"Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reem A","family":"Alsudairi","sequence":"additional","affiliation":[{"name":"Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maha M","family":"Alosaimi","sequence":"additional","affiliation":[{"name":"Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ghada A","family":"Alnasser","sequence":"additional","affiliation":[{"name":"Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rawan A","family":"Abuzaid","sequence":"additional","affiliation":[{"name":"Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Najma","family":"Khalil","sequence":"additional","affiliation":[{"name":"Department of Medicine, Rheumatology Unite, King Saud University and Medical City, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanan H","family":"Abouzaid","sequence":"additional","affiliation":[{"name":"Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulrahman S","family":"Alarfaj","sequence":"additional","affiliation":[{"name":"Department of Medicine, Rheumatology Unite, King Saud University and Medical City, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,5]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrclinonc.2009.146"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.2165\/00003495-199142050-00005"},{"key":"e_1_3_3_4_2","first-page":"711","article-title":"Toxic effects of different doses of cyclophosphamide on liver and kidney tissue in Swiss albino mice: a histopathological study","volume":"28","author":"Bhat N","year":"2018","unstructured":"Bhat N, Kalthur SG, Padmashali S, et\u00a0al. Toxic effects of different doses of cyclophosphamide on liver and kidney tissue in Swiss albino mice: a histopathological study. Ethiop J Health Sci 2018; 28: 711\u2013716.","journal-title":"Ethiop J Health Sci"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3565(25)38491-0"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.lfs.2018.12.018"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.25061"},{"key":"e_1_3_3_8_2","first-page":"1","article-title":"Haemorrhagic cystitis in haematopoietic stem cell transplantation (HSCT): a prospective observational study of incidence and management in HSCT centres within the GITMO network (Gruppo Italiano Trapianto Midollo Osseo)","volume":"8","author":"Gargiulo G","year":"2014","unstructured":"Gargiulo G, Orlando L, Alberani F, et\u00a0al. Haemorrhagic cystitis in haematopoietic stem cell transplantation (HSCT): a prospective observational study of incidence and management in HSCT centres within the GITMO network (Gruppo Italiano Trapianto Midollo Osseo). Ecancermedicalscience 2014; 8: 1\u201312.","journal-title":"Ecancermedicalscience"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2015.162"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1188\/15.CJON.E8-E14"},{"key":"e_1_3_3_11_2","doi-asserted-by":"crossref","unstructured":"Vose JM Reed EC Pippert GC et al. Mesna compared with continuous bladder irrigation as uroprotection during high-dose chemotherapy and transplantation: a randomized trial. J Clin Oncol 1993; 11: 1306\u20131310.","DOI":"10.1200\/JCO.1993.11.7.1306"},{"key":"e_1_3_3_12_2","first-page":"199","article-title":"Mechanisms of hemorrhagic cystitis","volume":"2","author":"Haldar S","year":"2014","unstructured":"Haldar S, Dru C, Bhowmick NA. 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