Duration of sweat cyclophosphamide excretion in patients undergoing a conditioning regimen of high-dose cyclophosphamide for hematopoietic stem-cell transplantation

Abstract

Purpose

To investigate the duration of cyclophosphamide (CPA) excretion in the sweat after administration when receiving high-dose CPA therapy as a conditioning regimen for hematopoietic stem-cell transplantation (HSCT).

Methods

Shirts and pillowcases samples (changed once a day) from 12 patients, categorized as groups 1 (n  =  6), 2 (n = 4), and 3 (n  =  2), receiving high-dose CPA therapy were collected, sealed, stored at 4°C, and mailed to an analytical facility for CPA estimation using LC-MS/MS. CPA was administered intravenously at a dose of 60 mg/kg on days 1, 2 (closed-system delivery for group 3), and samples were collected during days 1–4 (groups 1,3) or days 1–9 (group 2).

Results

CPA was detected in all 126 shirts and pillowcases. In 9 patients, excluding 1 patient who had fever during the study period and group 3 patients, the mean (range) rate of CPA excretion in sweat was 0.03% (0.01–0.12%). The mean CPA excretion in 9 patients adjusted for body weight was 19.9 μg/kg on day 1 and 0.3 μg/kg on day 4.

Conclusions

This study showed that CPA was excreted for an extended duration in the patient's sweat, receiving a high-dose CPA therapy as a conditioning regimen against HSCT.