However toxicity (including alopecia) is less than might be expected and in combination with pulse steroids cyclophosphamide is often well tolerated.
Combinations containing cisplatin, cyclophosphamide and doxorubicin were studied in the 1980s and showed improved median progression-free survival.
Conditioning regimens included cyclophosphamide, cytarabine, and total body irradiation.
The aim is to achieve high concentrations of activated cyclophosphamide locally in the tumor while minimizing circulating levels of the drug.
For very severe disease causing inflammation in the kidneys, lungs or brain then we use cyclophosphamide with high doses of steroids.