What is the treatment for cyclophosphamide-induced hemorrhagic cystitis?

Cyclophosphamide is a chemotherapeutic agent that can cause hemorrhagic cystitis, a condition characterized by inflammation and bleeding in the bladder. This side effect is primarily due to the accumulation of a toxic metabolite called acrolein, which irritates the bladder wall.

Mesna is a cytoprotective agent specifically used to mitigate the risk of hemorrhagic cystitis caused by cyclophosphamide. It acts by binding to the toxic metabolites, particularly acrolein, and neutralizing them, thereby preventing tissue damage in the bladder. By administering Mesna, the incidence of hemorrhagic cystitis can be significantly reduced in patients undergoing treatment with cyclophosphamide.

While other options may have merits in different contexts, they are not appropriate or effective treatments for cyclophosphamide-induced hemorrhagic cystitis. For example, fluids and rest might help with overall hydration but do not specifically target the bladder toxicity. Aminoglycosides are antibiotics and do not have a role in treating this condition, and furosemide, a diuretic, could worsen dehydration and does not address the underlying pathology of hemorrhagic cystitis. Thus, the correct treatment to prevent or manage this complication is Mesna.