Does cyclophosphamide induce bladder cancer?

Richard M. Pearson, Mark S. Soloway

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

An increasing incidence of bladder neoplasms temporally associated with chemotherapy, usually cyclophosphamide, is being reported. These secondary primary bladder malignancies are characteristically found in two groups of patients: those with lymphoproliferative or myeloproliferative tumors, and those with immunosuppression after organ transplantation. A case of adenocarcinoma of the bladder associated with malignant lymphoma is reported, and the known cases of second primary bladder malignancies after cyclophosphamide therapy as reported in the literature are reviewed. Studies relating to the enhanced occurrence of second primary cancers in lymphoproliferative disorders are presented. The recognized urologic toxicities of cyclophosphamide, including cytopathologic changes in animals and humans, are discussed. The observed association between immunosuppression and second primary malignancies is explored, as supported by studies on congenital immunodeficiency in humans, viral oncogenesis in experimental animals, and neoplasia after organ transplantation. Possible mechanisms of carcinogenesis associated with cyclophosphamide are reviewed, including suppression of humoral and cell-mediated immune defense mechanisms, direct carcinogenesis, or cocarcinogenesis. A plea is made for the orderly reporting and careful documentation of bladder tumors in patients receiving cyclophosphamide. It is suggested that prospective studies in these patients and in patients receiving cyclophosphamide for nonmalignant disorders would be of value in assessing the culpability of cyclaphosphamide as a carcinogen.

Original languageEnglish
Pages (from-to)437-447
Number of pages11
JournalUrology
Volume11
Issue number5
DOIs
StatePublished - Jan 1 1978
Externally publishedYes

Fingerprint

Urinary Bladder Neoplasms
Cyclophosphamide
Carcinogenesis
Urinary Bladder
Second Primary Neoplasms
Organ Transplantation
Immunosuppression
Cocarcinogenesis
Neoplasms
Lymphoproliferative Disorders
Documentation
Carcinogens
Lymphoma
Adenocarcinoma
Prospective Studies
Drug Therapy
Incidence

ASJC Scopus subject areas

  • Urology

Cite this

Does cyclophosphamide induce bladder cancer? / Pearson, Richard M.; Soloway, Mark S.

In: Urology, Vol. 11, No. 5, 01.01.1978, p. 437-447.

Research output: Contribution to journalArticle

Pearson, RM & Soloway, MS 1978, 'Does cyclophosphamide induce bladder cancer?', Urology, vol. 11, no. 5, pp. 437-447. https://doi.org/10.1016/0090-4295(78)90154-1
Pearson, Richard M. ; Soloway, Mark S. / Does cyclophosphamide induce bladder cancer?. In: Urology. 1978 ; Vol. 11, No. 5. pp. 437-447.
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