Ask the Experts - Cyclophosphamide for Wegener's Granulomatosis
Ask the Experts - Cyclophosphamide for Wegener's Granulomatosis
A patient with a severe form of Wegener's granulomatosis is receiving high doses of cyclophosphamide. Monitoring leukocyte count may prevent possible toxicity. Does it also give indirect evidence for the efficacy of the treatment? Is there an optimum level of white blood cell (WBC) count for this patient? Is it acceptable for this patient to receive different doses of cyclophosphamide on alternate days (for example, 100 mg one day and 150 mg the other)?
Typically, the use of cyclophosphamide for vasculitis is designed to lower the WBC count to between 2000-3000/mm, and achieving that level is usually associated with improved response. Induction therapy usually requires daily oral or intravenous therapy, but after control is achieved, administering cyclophosphamide every other day or even once per month intravenously might be very helpful to decrease risk for total dose exposure and for other potential toxic effects.
A patient with a severe form of Wegener's granulomatosis is receiving high doses of cyclophosphamide. Monitoring leukocyte count may prevent possible toxicity. Does it also give indirect evidence for the efficacy of the treatment? Is there an optimum level of white blood cell (WBC) count for this patient? Is it acceptable for this patient to receive different doses of cyclophosphamide on alternate days (for example, 100 mg one day and 150 mg the other)?
Typically, the use of cyclophosphamide for vasculitis is designed to lower the WBC count to between 2000-3000/mm, and achieving that level is usually associated with improved response. Induction therapy usually requires daily oral or intravenous therapy, but after control is achieved, administering cyclophosphamide every other day or even once per month intravenously might be very helpful to decrease risk for total dose exposure and for other potential toxic effects.