Mesna compared with continuous bladder irrigation as uroprotection during high-dose chemotherapy and transplantation: A randomized trial

J. M. Vose, E. C. Reed, G. C. Pippert, J. R. Anderson, P. J. Bierman, A. Kessinger, J. Spinolo, J. O. Armitage

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Abstract

Purpose: To compare the use of intravenous (IV) hydration plus either continuous bladder irrigation or mesna for the prevention of hemorrhagic cystitis in the bone marrow transplant setting. Patients and Methods: Two hundred patients were prospectively randomized to receive either continuous bladder irrigation with 200 mL/h of normal saline, or continuous infusion mesna at 100% of the cyclophosphamide dose. Results: The overall incidence of hematuria of any grade was significantly higher in the bladder-irrigation group (76%) compared with the mesna group (53%) (P = .007). However, the incidence of grade III and IV hematuria was the same in both groups (18%; P = NS). Moderate or severe discomfort or bladder spasms were reported in 84% of the patients who received bladder irrigation, compared with 2% of the patients who received mesna prophylaxis (P < .0001). Urinary tract infections (UTIs) were documented in 27% of the patients in the bladder-irrigation group, compared with 14% of the patients in the mesna group (P = .03). Conclusion: Both continuous bladder irrigation and mesna were equally effective in preventing severe hemorrhagic cystitis associated with high- dose cyclophosphamide and bone marrow transplantation. However, the use of mesna was associated with significantly less discomfort and a lower incidence of UTIs.

Original languageEnglish (US)
Pages (from-to)1306-1310
Number of pages5
JournalJournal of Clinical Oncology
Volume11
Issue number7
DOIs
StatePublished - Jan 1 1993

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Mesna
Urinary Bladder
Transplantation
Drug Therapy
Cystitis
Hematuria
Urinary Tract Infections
Cyclophosphamide
Incidence
Spasm
Bone Marrow Transplantation
Bone Marrow
Transplants

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Mesna compared with continuous bladder irrigation as uroprotection during high-dose chemotherapy and transplantation : A randomized trial. / Vose, J. M.; Reed, E. C.; Pippert, G. C.; Anderson, J. R.; Bierman, P. J.; Kessinger, A.; Spinolo, J.; Armitage, J. O.

In: Journal of Clinical Oncology, Vol. 11, No. 7, 01.01.1993, p. 1306-1310.

Research output: Contribution to journalArticle

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T1 - Mesna compared with continuous bladder irrigation as uroprotection during high-dose chemotherapy and transplantation

T2 - A randomized trial

AU - Vose, J. M.

AU - Reed, E. C.

AU - Pippert, G. C.

AU - Anderson, J. R.

AU - Bierman, P. J.

AU - Kessinger, A.

AU - Spinolo, J.

AU - Armitage, J. O.

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N2 - Purpose: To compare the use of intravenous (IV) hydration plus either continuous bladder irrigation or mesna for the prevention of hemorrhagic cystitis in the bone marrow transplant setting. Patients and Methods: Two hundred patients were prospectively randomized to receive either continuous bladder irrigation with 200 mL/h of normal saline, or continuous infusion mesna at 100% of the cyclophosphamide dose. Results: The overall incidence of hematuria of any grade was significantly higher in the bladder-irrigation group (76%) compared with the mesna group (53%) (P = .007). However, the incidence of grade III and IV hematuria was the same in both groups (18%; P = NS). Moderate or severe discomfort or bladder spasms were reported in 84% of the patients who received bladder irrigation, compared with 2% of the patients who received mesna prophylaxis (P < .0001). Urinary tract infections (UTIs) were documented in 27% of the patients in the bladder-irrigation group, compared with 14% of the patients in the mesna group (P = .03). Conclusion: Both continuous bladder irrigation and mesna were equally effective in preventing severe hemorrhagic cystitis associated with high- dose cyclophosphamide and bone marrow transplantation. However, the use of mesna was associated with significantly less discomfort and a lower incidence of UTIs.

AB - Purpose: To compare the use of intravenous (IV) hydration plus either continuous bladder irrigation or mesna for the prevention of hemorrhagic cystitis in the bone marrow transplant setting. Patients and Methods: Two hundred patients were prospectively randomized to receive either continuous bladder irrigation with 200 mL/h of normal saline, or continuous infusion mesna at 100% of the cyclophosphamide dose. Results: The overall incidence of hematuria of any grade was significantly higher in the bladder-irrigation group (76%) compared with the mesna group (53%) (P = .007). However, the incidence of grade III and IV hematuria was the same in both groups (18%; P = NS). Moderate or severe discomfort or bladder spasms were reported in 84% of the patients who received bladder irrigation, compared with 2% of the patients who received mesna prophylaxis (P < .0001). Urinary tract infections (UTIs) were documented in 27% of the patients in the bladder-irrigation group, compared with 14% of the patients in the mesna group (P = .03). Conclusion: Both continuous bladder irrigation and mesna were equally effective in preventing severe hemorrhagic cystitis associated with high- dose cyclophosphamide and bone marrow transplantation. However, the use of mesna was associated with significantly less discomfort and a lower incidence of UTIs.

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