Cyclophosphamide is one of the nitrogen mustard class of alkylating agents. It alkylates DNA, especially in proliferating cells. B- and T- lymphocytes are both affected, although the effects are greater on B-cells and therefore on humoral immunity. When large doses of cyclophosphamide are given at the same time as a new antigenic insult, specific tolerance to the antigen may develop.
Side effects
Bone marrow suppression with
pancytopaenia. Blood count should be checked regularly during treatment.
Teratogenic.
Haemorrhagic cystitis secondary to excretion of the toxic
metabolite acrolein in the urine. When using high doses of intravenous
cyclophosphamide, the agent MESNA is given to neutralise the acrolein.