Chemical class: oxazaphosphorines
Toxicity is often dose-related but may occur after minimal exposure.
Nonspecific urinary tract symptoms that may develop in patients;
(1) frequency
(2) urgency
(3) dysuria
(4) nocturia
Changes in the urinary bladder:
(1) fibrosis
(2) hematuria, ranging from microscopic to gross hematuria
(3) diffuse inflammation (cystitis), with mucosal edema
(4) telangiectasia
(5) mucosal ulceration
(6) atypia progressing to malignancy (late toxicity)
Therapeutic interventions:
(1) discontinuation of therapy
(2) hydration and diuresis
(3) bladder irrigation
(4) intravenous mesna therapy (sodium 2-mercaptoethane)
The toxic effects may be potentiated by:
(1) previous pelvic irradiation
(2) concurrent therapy with busulfan
