Which chemotherapy agent requires special monitoring due to potential bladder damage?

Cyclophosphamide is the chemotherapy agent that requires special monitoring due to its potential to cause bladder damage. This risk is primarily associated with the metabolite acrolein, which can irritate the bladder lining and lead to hemorrhagic cystitis, a painful condition characterized by inflammation and bleeding in the bladder.

To mitigate this risk, patients receiving cyclophosphamide are often advised to maintain adequate hydration and may be given mesna, a protective agent that binds to acrolein and reduces its harmful effects on the bladder. This proactive approach is essential in preventing complications associated with cyclophosphamide therapy, making awareness of its potential bladder toxicity critical in patient care.

When considering other chemotherapy agents such as doxorubicin, paclitaxel, and cisplatin, while each has its own set of specific toxicities and monitoring requirements, they do not possess the same significant bladder-related risks as cyclophosphamide. This distinction is key for healthcare professionals in managing and anticipating side effects during treatment.