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Hyperbaric oxygen as a treatment modality in cyclophosphamide-induced hemorrhagic cystitis.

Authors
  • Kaur, Dominder1
  • Khan, Shakila P2, 3
  • Rodriguez, Vilmarie2, 3
  • Arndt, Carola2
  • Claus, Paul4
  • 1 Division of Hematology/Oncology & BMT, Nationwide Children's Hospital, Columbus, OH, USA.
  • 2 Division of Pediatric Hematology Oncology, Mayo Clinic, Rochester, MN, USA.
  • 3 Division of Pediatric Hematology Oncology and Bone Marrow Transplantation, Mayo Clinic, Rochester, MN, USA.
  • 4 Division of Hyperbaric and Altitude Medicine, Mayo Clinic, Rochester, MN, USA.
Type
Published Article
Journal
Pediatric Transplantation
Publisher
Wiley (Blackwell Publishing)
Publication Date
Jun 01, 2018
Volume
22
Issue
4
Identifiers
DOI: 10.1111/petr.13171
PMID: 29569791
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Late-onset HC is a well-recognized complication associated with cyclophosphamide/acrolein-induced toxicity. It poses a management challenge when hyperhydration and bladder irrigation do not result in clinical improvement as desired. The data regarding use of hyperbaric oxygen therapy (HBO2) as an early treatment modality in this clinical setting are limited. We present 2 cases, that were refractory to hyperhydration and bladder irrigation but responded to HBO2. They were treated with 20-30 daily sessions over weekdays with 100% oxygen for 90 minutes at 2 atmospheric pressure units (2 atm). Both patients reported improved symptoms within the first 15 sessions, and hematuria diminished by 20 sessions. Hyperbaric oxygen is a less invasive, outpatient therapy that is effective for treatment of HC and is tolerated well by young patients. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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