(Cyclophosphamide) (320- CSDT 12th)* Haemorrhagic cystitis can develop in patients recieving cyclophosphamide or Ifosamide* Other drugs causing hemorrhagic cystitis- Carmustine- Chlorumbucil- Extended spectrum penicilline- Nitrogen mustard- Vincristine* Remember these following two very important points* Hemorrhagic cystitis due to cyclophosphamide is attributed to the presence of its metabolite ACROLEIN in urine* Hemorrhage cystitis due to cyclophosphamide can be prevented by I.V- injection of MESNA (Sodium- 2 mercaptoethane sulfonate) and adequate hydration* Haemorrhagic cystitis is also seen in patients who undergo Bone marrow transplantation (BMT)* In BMT setting1. Early onset haemorrhagic cystitis - due to drugs (cyclophosphamide)2. Late onset haemorrhagic cystitis - due to polyoma virus BKV or adenovirus type II