Severe cyclophosphamide-induced haemorrhagic cystitis treated with hyperbaric oxygen
Michael Davis, Heather MacDonald, Christopher Sames, Kushma Nand
Cyclophosphamide, a drug used widely in cancer and connective-tissue disease, may cause bleeding from the bladder (haemorrhagic cystitis) due to a toxic metabolite excreted in the urine. Rarely, this bleeding is so severe as to be life-threatening. Because radiation cystitis often responds to hyperbaric oxygen therapy (HBOT), and the changes seen in the bladder wall under the microscope in cyclophosphamide cystitis are similar, it has been suggested that HBOT would be effective in treating this problem. Between 2000 and 2007, six such patients were treated with HBOT in the three hyperbaric medicine units in New Zealand and all had complete cessation of bleeding on at least one years follow-up.
