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Patient information - Mobilisation - Cyclophosphamide

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This information sheet outlines your treatment. It should be reviewed together with your doctor, nurse or pharmacist to address any questions or concerns.

The treatment schedule below explains when you will receive the medicines and how they are given.  Your doctor, nurse or pharmacist will be able to explain how your treatment works in more detail.

The treatment schedule below explains how the drugs for this treatment are given.

Cyclophosphamide 
Day Treatment How it is given How long it takes
1 Mesna (MES-na) By a drip into a vein About 5 hours 
Cyclophosphamide (SYE-kloe-FOS-fa-mide) By a drip into a vein About 1 hour
3 onwards Filgrastim (fil-GRAS-tim) By injection under the skin About 5 minutes TWICE a day until stem cells have been harvested

This treatment is usually given once. You may be in hospital for 2 to 3 days, or this treatment may be given in the outpatient setting. Your doctor will discuss this with you.

This treatment can sometimes cause serious problems. It is important to get medical help immediately if you become unwell.

Emergency

IMMEDIATELY go to your nearest hospital Emergency Department, or contact your doctor or nurse if you have any of the following at any time:

Emergency contact details

Ask your doctor or nurse from your treating team who to contact if you have a problem

 

  • a temperature of 38ºC or higher
  • chills, sweats, shivers or shakes
  • shortness of breath
  • uncontrolled vomiting or diarrhoea
  • pain, tingling or discomfort in your chest or arms
  • you become unwell.
Daytime:
Night/weekend:
Other instructions:

During your treatment immediately tell the doctor or nurse looking after you if you get any of the following problems: 

  • leaking from the area where the drugs are being given 
  • pain, stinging, swelling or redness in the area where the drugs are being given or at any injection sites
  • a skin rash, itching, feeling short of breath, wheezing, fever, shivers, or feeling dizzy or unwell in any way (allergic reaction).

Blood tests and monitoring

You will need to have regular blood tests. There are times when you may need a blood test every day.

Other medications given during this treatment

  • Anti-sickness (anti-nausea) medication: you may be given some anti-sickness medication. Make sure you take this medication as your doctor or nurse tells you, even if you don’t feel sick. This can help to prevent the sickness starting.
  • G-CSF: you will be given injection(s) of a drug called G-CSF (also called filgrastim) under your skin. This helps to boost both your white blood cell count and the number of stem cells available in your blood stream, making it possible to collect them. These injections will continue until your stem cells are collected. Follow this link to read more information on how to give this injection opens in a new tab or window.

Cancer treatments can cause damage to normal cells in your body, which can cause side effects. Everyone gets different side effects, and some people will have more problems than others.

The table below shows some of the side effects you may get with this treatment. You are unlikely to get all of those listed and you may also get some side effects that have not been listed.

Tell your doctor or nurse about any side effects that worry you. Follow the instructions below and those given to you by your doctor or nurse.

Immediate (onset hours to days)

Bone pain after G-CSF injection

  • You may have discomfort or a dull ache in your pelvis, back, arms or legs.
  • To reduce the pain, take paracetamol before each injection.
  • Tell your doctor or nurse as soon as possible if your pain is not controlled.

Bladder irritation (haemorrhagic cystitis)

  • You may get: 
    • blood in your urine, sometimes with blood clots
    • pain or burning when you urinate
    • the urge to urinate more than normal
    •  stomach or pelvic pain or discomfort.
  • When you go home, make sure you drink plenty of fluids (unless you are fluid restricted).
  • Empty your bladder often.
  • Tell your doctor or nurse as soon as possible if you notice any blood in your urine.

Nausea and vomiting

  • You may feel sick (nausea) or be sick (vomit).
  • Take your anti-sickness medication as directed even if you don’t feel sick.
  • Drink plenty of fluids (unless you are fluid restricted).
  • Eat small meals more frequently.
  • Try food that does not require much preparation.
  • Try bland foods like dry biscuits or toast.
  • Gentle exercise may help with nausea.
  • Ask your doctor or nurse for eviQ patient information - Nausea and vomiting during cancer treatment. 
  • Tell your doctor or nurse immediately, or go to the nearest hospital Emergency Department if you have uncontrolled vomiting or feel dizzy or light-headed.

Taste and smell changes

  • You may find that food loses its taste or tastes different.
  • These changes are likely to go away with time.
  • Do your mouth care regularly.
  • Chew on sugar-free gum or eat sugar-free mints.
  • Add flavour to your food with sauces and herbs.
  • Ask your doctor or nurse for eviQ patient information - Taste and smell changes during cancer treatment.

Early (onset days to weeks)

Infection risk (neutropenia)

  • This treatment lowers the amount of white blood cells in your body. The type of white blood cells that help to fight infection are called neutrophils. Having low level of neutrophils is called neutropenia. If you have neutropenia, you are at greater risk of getting an infection. It also means that your body can’t fight infections as well as usual. This is a serious side effect, and can be life threatening.
  • Wash your hands often.
  • Keep a thermometer at home and take your temperature regularly, and if you feel unwell.
  • Do your mouth care regularly.
  • Inspect your central line site (if you have one) daily for any redness, pus or swelling.
  • Limit contact with people who are sick.
  • Learn how to recognise the signs of infection.
  • Ask your doctor or nurse for eviQ patient information - Infection during cancer treatment.
  • Tell your doctor or nurse immediately, or go to the nearest hospital Emergency Department if you get any of the following signs or symptoms:
    • a temperature of 38°C or higher
    • chills, shivers, sweats or shakes
    • a sore throat or cough
    • uncontrolled diarrhoea
    • shortness of breath
    • a fast heartbeat
    •  become unwell even without a temperature.

Low platelets (thrombocytopenia)

  • This treatment lowers the amount of platelets in your blood. Platelets help your blood to clot. When they are low, you are at an increased risk of bleeding and bruising.
  • Try not to bruise or cut yourself.
  • Avoid contact sport or vigorous exercise. 
  • Clear your nose by blowing gently.
  • Avoid constipation.
  • Brush your teeth with a soft toothbrush.
  • Don't take aspirin, ibuprofen or other similar anti-inflammatory medications unless your doctor tells you to.
  • Tell your doctor or nurse if you have any bruising or bleeding. 
  • Tell your doctor or nurse immediately, or go to your nearest hospital Emergency Department if you have any uncontrolled bleeding.

Diarrhoea

  • You may get bowel motions (stools, poo) that are more frequent or more liquid.
  • You may also get bloating, cramping or pain.
  • Take your antidiarrhoeal medication as directed by your doctor.
  • Drink plenty of fluids (unless you are fluid restricted).
  • Eat and drink small amounts more often.
  • Avoid spicy foods, dairy products, high fibre foods, and coffee.
  • Ask your doctor or nurse for eviQ patient information - Diarrhoea during cancer treatment. 
  • Tell your doctor or nurse immediately, or go to your nearest hospital Emergency Department if your diarrhoea is not controlled, you have 4 or more loose bowel motions per day, and if you feel dizzy or light-headed.

Tiredness and lack of energy (fatigue)

  • You may feel very tired, have no energy, sleep a lot, and not be able to do normal activities or things you enjoy.
  • Do not drive or operate machinery if you are feeling tired.
  • Nap for short periods (only 1 hour at a time)
  • Prioritise your tasks to ensure the best use of your energy.
  • Eat a well balanced diet and drink plenty of fluids (unless you are fluid restricted).
  • Try some gentle exercise daily.
  • Allow your friends and family to help.
  • Tell your doctor or nurse if you get any of the symptoms listed above.

Extra fluid in the body (fluid retention)

  • You may gain weight over a short amount of time.
  • Your hands and feet may become swollen, appear red or feel hot and uncomfortable.
  • Wear loose clothing and shoes that are not too tight.
  • Try not to stand up or walk around too much at one time.
  • If your ankles or legs get swollen, try raising them.
  • Make sure that any cuts or areas of broken skin are treated as soon as possible.
  • Tell your doctor or nurse as soon as possible if you get any of the symptoms listed above or gain 1 to 2 kg in a week.
  • Tell your doctor or nurse immediately or go to the nearest hospital Emergency Department if you become short of breath. 

Kidney damage

  • This treatment can cause changes to how your kidneys work.
  • You will have blood tests to make sure your kidneys are working properly.
  • You may need to drink more fluids while you are having treatment. Your doctor or nurse will tell you if you need to do this.
  • Tell your doctor or nurse as soon as possible if you notice that your urine changes colour or you don't need to empty your bladder as often.

Oesophagus inflammation (oesophagitis)

  • You may get heartburn or have difficult or painful swallowing.
  • Eat small meals that are high in protein and calories.
  • Avoid eating acidic, hot, salty or spicy foods, and drinking alcohol.
  • Sit upright when eating.
  • Ask to speak with a dietitian if you are having trouble eating.
  • Tell your doctor or nurse as soon as possible if you have the any of the symptoms listed above and they are suddenly getting worse.

Mouth pain and soreness (mucositis)

  • You may have:
    • bleeding gums
    • mouth ulcers
    • a white coating on your tongue
    • pain in the mouth or throat
    • difficulty eating or swallowing.
  • Avoid spicy, acidic or crunchy foods and very hot or cold food and drinks.
  • Try bland and soft foods.
  • Brush your teeth gently with a soft toothbrush after each meal and at bedtime. If you normally floss continue to do so.
  • Rinse your mouth after you eat and brush your teeth, using either:
    • 1/4 teaspoon of salt in 1 cup of warm water, or
    •  1/4 teaspoon of bicarbonate of soda in 1 cup of warm water
  • Ask your doctor or nurse for eviQ patient information - Mouth and throat problems during cancer treatment. 
  • Tell your doctor or nurse if you get any of the symptoms listed above.

Skin rash

  • You may get a red, bumpy rash and dry, itchy skin. 
  • Moisturise your skin with a gentle non-perfumed moisturising cream like sorbolene or aqueous cream.
  • Do not scratch your skin.
  • Protect your skin from the sun by wearing sun-protective clothing, a wide-brimmed hat, sunglasses and sunscreen of SPF 50 or higher.
  • Talk to your doctor or nurse about other ways to manage your skin rash.

Late (onset weeks to months)

Low red blood cells (anaemia)

  • You may feel dizzy, light-headed, tired and appear more pale than usual.
  • Tell your doctor or nurse if you have any of these signs or symptoms. You might need a blood transfusion.
  • Tell your doctor or nurse immediately, or go to the nearest hospital Emergency Department if you have any chest pain, trouble breathing, or feel like your heart is racing.

Hair loss (alopecia)

  • Your hair may start to fall out from your head and body.
  • Hair loss usually starts 2 to 3 weeks after your first treatment.
  • You may become completely bald and your scalp might feel tender.
  • Use a gentle shampoo and a soft brush.
  • Take care with hair products like hairspray, hair dye, bleaches and perms.
  • Protect your scalp from the cold with a hat, scarf or wig.
  • Protect your scalp from the sun with a hat or sunscreen of SPF 50 or higher.
  • Moisturise your scalp to prevent itching.
  • Ask your doctor or nurse about the Look Good Feel Better opens in a new tab or window program 

Chemo brain (chemotherapy-related cognitive impairment)

  • You may notice that you are unable to concentrate, feel unusually disorganised or tired (lethargic) and have trouble with your memory.
  • These symptoms usually improve once treatment is completed.
  • Ask your doctor or nurse for eviQ patient information – Memory changes and chemotherapy (chemo brain). 
  • Tell your doctor or nurse if you get any of the symptoms listed above.

Delayed (onset months to years)

Lung problems

  • Lung problems are rare, but can be serious. They may occur throughout treatment or after the completion of treatment. 
  • You may get:
    • shortness of breath
    • fever
    • dry cough
    • wheezing
    • fast heartbeat
    •  chest pain.
  • Your doctor will monitor how well your lungs are working during your treatment.
  • Tell your doctor or nurse immediately, or go to the nearest hospital Emergency Department if you have chest pain or become short of breath.

Chemotherapy safety

  • Learn how to keep you and your family safe while you are having anticancer drugs.
  • See our patient information sheet - Chemotherapy safety at home. 

Blood clot risk

  • Cancer and anticancer drugs can increase the risk of a blood clot (thrombosis).
  • Tell your doctor if you have a family history of blood clots.
  • A blood clot can cause pain, redness, swelling in your arms or legs, shortness of breath or chest pain.
  • If you have any of these symptoms go to your nearest hospital Emergency Department.

Medications and vaccinations 

  • Before you start treatment, tell your doctor and pharmacist about any medications you are taking, including over-the-counter products, vitamins or herbal supplements.
  • Don’t stop or start any medications during treatment without talking to your doctor and pharmacist first.
  • Paracetamol is safe to take if you have a headache or other mild aches and pains. It is recommended that you avoid taking aspirin, ibuprofen and other anti-inflammatory type medications for pain while you are having treatment. However, if these medications have been prescribed by your doctor, do not stop taking them without speaking with your doctor.
  • You should not have any vaccinations while your white blood cell count is extremely low. A revaccination schedule should begin at 6 months post transplant; however, you will not be given any live vaccines until at least 2 years after your transplant and your immune system has returned to normal. If you are unsure, check with your doctor before you have any vaccinations. 
  • People you live with should be fully vaccinated, including having live vaccines according to the current vaccination schedule. Extra care needs to be taken with hand washing and careful disposal of soiled nappies for infants who have recently received the rotavirus vaccine.

Other medical and dental treatment

  • If you go to hospital or any other medical appointment (including dental appointments), always tell the person treating you that you are receiving anticancer drugs.
  • Before you have any dental treatment, talk to your doctor. 

Diet and food safety 

  • While you are receiving this treatment, it is important that you try to maintain a healthy diet.
  • Grapefruit and grapefruit juice can interact with your medication and should be avoided while you are on this treatment. 
  • Speak to your doctor or nurse about whether drinking alcohol is safe with your treatment.
  • If you have any concerns about recent weight loss or weight gain or questions about your diet, ask to speak to a dietitian.
  • Avoid drinking or cooking with untreated water (e.g. water from rainwater tanks, bores or rivers) due to risk of contamination. If you intend to drink or cook with rainwater, you should bring it to a boil and allow the water to cool down before drinking or cooking with it. For more information see the NSW Health - Rainwater tanks opens in a new tab or window webpage.
  • There are some foods that may cause infection in high risk individuals and should be avoided. For further information on foods to avoid and food hygiene please ask for a copy of the Listeria and food brochure opens in a new tab or window. 

Fertility

  • Some cancer treatments can reduce your fertility. This can make it difficult or impossible to get pregnant or father a child.
  • Talk to your doctor or nurse before you start any treatment. Depending on your situation there may be fertility sparing options available to you and/or your partner, discuss these with your doctor or nurse. 

Pregnancy and breastfeeding 

  • Some cancer treatments can be dangerous to unborn babies. Talk to your doctor or nurse if you think there is any chance that you could be pregnant.
  • Do not try to get pregnant or father a child during this treatment. Contraception should be used during treatment and after stopping treatment. Ask your doctor or nurse about what type of contraception you should use.
  • If you are planning pregnancy/fatherhood after completing this treatment, talk to your doctor. Some doctors advise waiting between 6 months and 2 years after treatment.
  • Do not breastfeed if you are on this treatment, as anti-cancer medications can also pass into breast milk.

Sex life and sexuality 

  • The desire to have sex may decrease as a result of this treatment or its side effects. 
  • Your emotions and the way you feel about yourself may also be affected by this treatment. 
  • It may help to discuss your concerns with your partner and doctor or nurse.

Risk of developing a second cancer 

  • Some anticancer treatments can increase your chance of developing a second cancer, this is rare. Your doctor will discuss with you the specific risks of your treatment.

Quitting smoking

  • It is never too late to quit smoking. Quitting smoking is one of the best things you can do to help your treatment work better.
  • There are many effective tools to improve your chances of quitting.
  • Talk to your treating team for more information and referral to a smoking cessation support service.

Staying active

  • Research shows that exercise, no matter how small, has many benefits for people during and after cancer treatment.
  • Talk to your doctor before starting an exercise program. Your doctor can advise whether you need a modified exercise program.

For more information about cancer treatment, side effects and side effect management see our Patient and carers section. 

Telephone support

  • Call Cancer Council on 13 11 20 for cancer information and support
  • Call the Leukaemia Foundation on 1800 620 420 (Mon to Fri 9am­ – 5pm)
  • Call the Lymphoma Nurse Support Line on 1800 953 081 (Mon to Fri 9am - 5pm)
  • Call the Myeloma Australia Support Line on 1800 693 566 (Mon to Fri 9am - 5pm)

Haematology, transplant and cellular therapy information

General cancer information and support

Quit smoking information and support

Quitting smoking is helpful even after you have been diagnosed with cancer. The following resources provide useful information and support to help you quit smoking. Talk to your treating team about any other questions you may have.

This document is a guide only and cannot cover every possible situation. Your treating team will consider your individual situation when making decisions about your care. Contact your doctor, nurse, pharmacist, or radiation therapist if you have any questions or concerns about your treatment, or you are having problems coping with side effects. While eviQ aims to provide reliable information, eviQ and the Cancer Institute NSW do not endorse or accept responsibility for the accuracy, currency, reliability or correctness of the content of linked external information sources. Use of this document is subject to eviQ’s disclaimer available at www.eviQ.org.au

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04 Jun 2025