Cyclophosphamide

IV has lower bladder toxicity vs oral

Immediate (e.g., gastrointestinal, susceptibility to infection)

The risk of future hematologic malignancy is related to total lifetime exposure (>36 g), as is myelofibrosis (>80 g).

Total lifetime exposure plus age constitutes a significant risk factor for premature ovarian failure (>7.5–15 g/m2 for young to older pediatric patients, respectively; 300 mg/kg for adults).

RITUX

[hypogammaglobulinaemia]https://pubmed.ncbi.nlm.nih.gov/30646343/9)

• check a baseline IgG & before eachcycle
• Sustained low IgG levels (≥4 months) were associated with increased risk for serious infections in open extension studies.
• About 20% of patients with normal IgG pre therapy develop HGG
• Those with existing HGG, 20% will worsen through mild-mod-severe stages
• severe infection in 33% of HGG
• IgG <6 g/L seems like 26% infection annually here. 15% had sever HGG