Which side effect is associated with mesna when given with cyclophosphamide?

Mesna is a protective agent used during chemotherapy with cyclophosphamide to prevent one of its well-known side effects, which is hemorrhagic cystitis. Cyclophosphamide can lead to the formation of toxic metabolites, particularly acrolein, which can irritate the bladder and cause bleeding. Mesna acts by binding to these toxic metabolites in the urine, thereby preventing them from damaging the bladder lining.

This protective effect is particularly crucial in patients receiving high doses of cyclophosphamide, as the risk of hemorrhagic cystitis increases with the dose and frequency of administration. While neurotoxicity, pulmonary edema, and mucositis can be associated with various chemotherapy agents, they are not primary concerns linked specifically to the use of mesna with cyclophosphamide. Understanding the role of mesna in mitigating the adverse effects of cyclophosphamide emphasizes the importance of supportive care in chemotherapy treatment protocols.