skip to main content

Cyclophosphamide Cancer Risk — ESENeph MCQ

Instant feedback + full explanation. One question, done properly.

ModerateRenal VasculitisCyclophosphamide Cancer RiskESENeph

A 45-year-old man with ANCA vasculitis achieves remission after Cyclophosphamide induction. His cumulative Cyclophosphamide dose was 15 g over 6 months. He asks about long-term cancer risk. What malignancy risk should be discussed?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Increased risk of bladder cancer and haematological malignancies; risk is dose-dependent (increases significantly above 36 g cumulative dose)

Cyclophosphamide is a known carcinogen. The risk of bladder cancer (transitional cell carcinoma) and haematological malignancies (myelodysplastic syndrome, leukaemia) increases with cumulative dose. The risk of bladder cancer increases significantly above 36 g cumulative dose. At 15 g, his risk is lower but not zero. KDIGO 2024 AAV guideline recommends that cumulative Cyclophosphamide dose should not exceed 36 g. Non-melanoma skin cancer risk is also increased. Lifelong surveillance (urine dipstick for haematuria, skin checks) is appropriate.

Reference: KDIGO 2024 – AAV Guideline; KDIGO 2021 – GN (Cyclophosphamide Toxicity)