Ciclofosfamida Guideline Summary

Indicaciones y Dosificación

The American College of Rheumatology recommends ciclofosfamida for lupus nephritis class III and IV, in combination with corticosteroids, with a dosing regimen of 0.5-1 g/m² monthly 2, 3
The American Society of Hematology suggests ciclofosfamida for vasculitis associated with ANCA, with a dosing regimen of 15 mg/kg (maximum 1500 mg) every 2-3 weeks 1
The British Association of Dermatologists recommends ciclofosfamida for pemphigus vulgaris, with a dosing regimen of 500 mg monthly or 15 mg/kg monthly 4, 5, 7
The American Society of Clinical Oncology recommends ciclofosfamida for breast cancer, with a dosing regimen of doxorubicin-ciclofosfamida x 4 → docetaxel x 4, or docetaxel-doxorubicin-ciclofosfamida x 6, or docetaxel-ciclofosfamida x 4 6

The National Institute for Health and Care Excellence recommends hydration to force diuresis and reduce urinary toxicity, and mesna administration with IV ciclofosfamida to prevent hemorrhagic cystitis 1
The American College of Rheumatology suggests trimethoprim/sulfamethoxazole for Pneumocystis jiroveci prophylaxis 1
The British Association of Dermatologists recommends regular monitoring of complete blood counts to adjust dosing, and monitoring of serum potassium, especially in patients with renal replacement therapy 8

The American Society of Clinical Oncology notes that ciclofosfamida can cause myelosuppression, with leucopenia, neutropenia, thrombocytopenia, and anemia 1
The British Association of Dermatologists reports that ciclofosfamida can cause gonadal toxicity, with amenorrhea (20-85% of women) and azoospermia in men 4, 5, 1
The National Institute for Health and Care Excellence warns of the risk of hemorrhagic cystitis, reduced with mesna and adequate hydration 1

The American Society for Reproductive Medicine recommends leuprolide during IV ciclofosfamida treatment for women, and sperm cryopreservation before treatment for men 2, 3