The addition of mesna to hyperhydration does not decrease the incidence of hemorrhagic cystitis in patients receiving high-dose cyclophosphamide

To assess the efficacy of hyperhydration Versus hyperhydration plus mesna in preventing cyclophosphamide induced hemorrhagic cystitis a retrospective analysis was conducted of 110 patients who received hyperhydration alone (baseline intravenous intake of at least 3.6 1/m(2)/day) and 107 patients who received hyperhydration plus mesna (120% of daily cyclophosphamide dose) while receiving cyclophosphamide (total dose 150-200 mg/kg) as part of a dose intensive regimen. Macroscopic hematuria was noted in 17 (16%) and 9 (8%) patients who received hyperhydration with or without mesna, respectively (p=0.08). This analysis failed to demonstrate a benefit in adding mesna to hyperhydration alone in preventing cyclophosphamide induced hemorrhagic cystitis.