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Bladder and kidney cancer following cyclophosphamide therapy for non-Hodgkin's lymphoma
Background: Cyclophosphamide is an established bladder carcinogen, but few studies have examined the relationship between dose and effect. The largest analysis to date included only seven cases of bladder cancer. No investigation has estimated the risk of kidney cancer. Purpose: The purpose of this study was to quantify the risk of bladder and kidney cancer following cyclophosphamide therapy. Methods: Within a cohort of 6171 two-year survivors of non-Hodgkin's lymphoma (NHL), 48 patients with secondary cancer of the urinary tract were identified and matched to 136 control subjects with NHL who did not develop a second malignancy. Detailed information on chemotherapeutic drugs and cumulative dose received was collected for all subjects. Radiation dose to the target organ was estimated from individual radiotherapy records. Evaluations of the risk of second cancer as a result of treatment with cyclophosphamide alone; radiation alone, or both therapies were made relative to those patients who were exposed to neither treatment modality. Results: A significant 4.5-fold risk of bladder cancer (95% confidence interval [CI]=1.5-13.6) followed therapy with cyclophosphamide, and risk was dependent upon cumulative dose. Among patients who received a total amount of cyclophosphamide of less than 20 g, a nonsignificant 2.4-fold risk of bladder cancer was apparent. Significantly elevated sixfold (95% CI=1.3-29) and 14.5-fold (95% CI=2.3-94) risks of bladder malignancy followed cumulative do
Oxford University Press
PMID : 7707439 ISSN : 0027-8874
Journal of the National Cancer Institute A. 1995, vol. 87, n° 7, pp. 524-530 [bibl. : 33 ref.]
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