Evaluation of surface contamination with cyclophosphamide in the home setting of outpatients on cancer chemotherapy

Abstract

Purpose: To monitor the urinary excretion of cyclophosphamide by five patients during the first 48 hours after cyclophosphamide administration and to evaluate surface contamination with cyclophosphamide in the patients’ homes via their excreta 48 hours after the completion of chemotherapy.

Methods: Urine samples were taken from five female patients with breast cancer at their homes during the 48 hours after administration of cyclophosphamide. Wipe samples were also collected from their home settings. All samples were analyzed for cyclophosphamide using gas chromatography with mass spectroscopy-mass spectrometry.

Results: Fifty-three urine samples were collected from the five patients during two days after cyclophosphamide treatment. Cyclophosphamide was positive in all urine samples. The quantity of cyclophosphamide excreted in each urine sample ranged from 0.09 to 65.99 mg. The urinary excretion of cyclophosphamide accounted for 9%–34% of the dose for four of the patients. Cyclophosphamide was measured at levels of 0.01–8.35 in 17 of the 28 wipe samples from all five patients. The areas contaminated with cyclophosphamide, common to all patients, were the toilet seat (0.04–8.35 ng/cm²) and the toilet floor (0.08–1.53 ng/cm²).

Conclusions: Surface contamination of the home settings of outpatients treated with cyclophosphamide was demonstrated 48 hours after cyclophosphamide administration. Contamination of the home setting with antineoplastic drugs administered to outpatients risks exposure to family members.