Hemorrhagic Cystitis With Low-Dose Cyclophosphamide Therapy for Breast Cancer: A Rare Occurrence

Abstract

Cyclophosphamide (CP) is known to cause hemorrhagic cystitis (HC), and this adverse effect is more commonly seen in patients receiving high individual doses used in the treatment of sarcomas and conditioning regimens during hematopoietic cell transplant. There are a few reported cases of HC in doses used for breast cancer. We report the case of a 63-year-old lady with stage IIA breast cancer who was started on adjuvant CP and docetaxel therapy at a dose of 600 mg/m 2 and 75 mg/m 2 respectively. She developed gross hematuria in less than 24 h after her first cycle and was found to have evidence suggestive of HC on cystoscopy done subsequently. She went on to complete three more cycles of adjuvant chemotherapy with CP and docetaxel with concurrent mesna and hydration. She did not develop any further episodes of hematuria. We review the literature pertaining to our case, and also compare the characteristics of the patient in our case with previously described cases of breast cancer who developed HC with low-dose CP. J Med Cases. 2019;10(6):179-182 doi: https://doi.org/10.14740/jmc3321