Which medications in the drug class Antineoplastics, Alkylating are used in the treatment of Granulomatosis with Polyangiitis (GPA, formerly Wegener Granulomatosis)?

Updated: Aug 31, 2021
  • Author: Christopher L Tracy, MD; Chief Editor: Herbert S Diamond, MD  more...
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Antineoplastics, Alkylating

These agents have improved the prognosis of GPA. Cyclophosphamide is initiated with high-dose corticosteroids but is continued for at least 3-6 months (until there is significant disease improvement and/or remission).


Cyclophosphamide is chemically related to nitrogen mustards. As an alkylating agent, cyclophosphamide's mechanism of action of active metabolites may involve cross-linking of deoxyribonucleic acid (DNA), which may interfere with the growth of normal and neoplastic cells. Complete blood cell (CBC) counts should be checked every 1-2 weeks while taking daily oral cyclophosphamide and at days 10 and 14 of each intravenous cyclophosphamide pulse to monitor for bone marrow suppression.

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