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Cyclophosphamide (INN, trade names Endoxan, Cytoxan, Neosar, Procytox, Revimmune, Cycloblastin), also known as cytophosphane and CP,〔National Cancer Dictionary: (cyclophosphamide )〕 is a nitrogen mustard alkylating agent from the oxazaphosphorine group. An alkylating agent adds an alkyl group to DNA. It attaches the alkyl group to the guanine base of DNA, at the number 7 nitrogen atom of the imidazole ring. This interferes with DNA replication by forming intrastrand and interstrand DNA crosslinks. Cyclophosphamide is used to treat cancers, autoimmune disorders, and AL amyloidosis. As a prodrug, it is converted by liver cytochrome P450 (CYP) enzymes to form the metabolite 4-hydroxy cyclophosphamide that has chemotherapeutic activity. Cyclophosphamide has severe and life-threatening adverse effects, including acute myeloid leukemia, bladder cancer, hemorrhagic cystitis, and permanent infertility, especially at higher doses. For autoimmune diseases, doctors often substitute less-toxic methotrexate or azathioprine after an acute crisis. It is on the World Health Organization's List of Essential Medicines, a list of the most important medication needed in a basic health system. ==Medical uses== Cyclophosphamide is used to treat cancers and autoimmune diseases. It is used to quickly control the disease. Because of its toxicity, it is discontinued as soon as possible, and replaced by less toxic drugs if necessary. Regular and frequent laboratory evaluations are required to monitor kidney function, avoid drug-induced bladder complications, and screen for bone marrow toxicity. Like other alkylating agents, cyclophosphamide is teratogenic and contraindicated in pregnant women (Pregnancy Category D) except for life-threatening circumstances in the mother. Additional relative contraindications to the use of cyclophosphamide include lactation, active infection, neutropenia, or bladder toxicity. It is used in medicine for treating certain cancers of the Islets of Langerhans and used in medical research to produce an animal model for Type 1 diabetes in a large dose as well as Type 2 diabetes with multiple low doses. 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Cyclophosphamide」の詳細全文を読む スポンサード リンク
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