Dosage of cyclophosphamide in different diseases

Non Hodgkin lymphoma:

Intravenous cyclophosphamide 400 to 600 mg per square body surface area given on day 1 every 21 days, as part of CVP (cyclophosphamide,  vincristine and prednisolone) regimen, and 750 mg per square body surface area given on day 1 every 21 days, as part of CHOP [cyclophosphamide, doxorubicin (hydroxydaunorubicin), vincristine (oncovin) and prednisolone] regimen.

Burkitt’s lymphoma:

Usually higher doses of intravenous  cyclophosphamide (1-4 gm per square body surface area) is used in Burkitt’s lymphoma in combination with other chemotherapeutic agents such as vincristine, methotrexate, doxorubicin and cytarabine.

Chronic lymphocytic leukemia (CLL):

Usual dose is intravenous cyclophosphamide 250 mg per square body surface area on days 2-4 on cycle 1 and on days 1-3 in subsequent cycles, as part of cyclophosphamide, rituximab and fludarabine regimen.

Breast cancer:

Tablet cyclophosphamide 100 mg per square body surface area on days 1-14 given every 28 days, or intravenous cyclophosphamide 600 mg per square body surface area given every 21 days as part of CMF (cyclophosphamide, methotrexate and fluorouracil) regimen.

Malignant pheochromocytoma:

Usual dose is intravenous cyclophosphamide 750 mg per square body surface area on day 1 every 21 days for 3 to 6 cycles, as part of Averbuch’s chemoyherapy protocol includes cyclophosphamide, vincristine and dacarbazine.

Systemic lupus erythematosus (SLE):

When given intravenously, the usual dose is 7 to 25 mg per kg body weight every month for 6 cycles. When given orally, the usual dose is 1.5 to 3 mg per kg body weight per day.

Multiple sclerosis:

Intravenous cyclophosphamide 700 mg per square body surface area monthly.

Mononeuritis multiplex:

Oral cyclophosphamide 2 mg per kg body weight per day.

Pemphigus vulgaris:

Tablet cyclophosphamide 1-2 mg per kg body weight per day.

Bullous pemphigoid:

Tablet cyclophosphamide 1-2 mg per kg body weight per day.

Wegener’s granulomatosis, Churg-Strauss syndrome and microscopic polyangiitis:

All are small vessel vasculitis. Cyclophosphamide is an effective therapy for the treatment of these vasculitis. It is given in doses of 2 mg per kg body weight per day orally together with glucocorticoids. After the induction of complete remission (complete disappearance of detectable disease), patients are maintained on cyclophosphamide therapy for up to a year to minimize the risk of relapse and gradually tapered and discontinued thereafter.

Goodpasture’s syndrome:

Usual dose is oral cyclophosphamide 2 mg per kg body weight per day together with prednisolone for two weeks.

Ewing’s sarcoma:

It is one type of malignant bone tumor. Intravenous cyclophosphamide 500 -1200 mg per square body surface area is used as chemotherapy in Ewing’s sarcoma in combination with other chemotherapeutic agents such as doxorubicin, etoposide, vincristine and dactinomycin.

Autoimmune hemolytic anemia:

Usually prednosolone is used to prevent hemolysis (breakdown of red boold cell) in autoimmune hemolytic anemia. If the hemolysis fails to respond to prednosolone, repeated cycles of cyclophosphamide at a dose of 50 mg per kg body weight per day for 4 days may be considered.

Bone marrow transplantation:

Usual dose is 60 mg per kg body weight intravenously for 2 days.