Clinical evaluation of cyclophosphamide therapy in patients with myasthenia gravis and thymoma

Objective To evaluate the efficacy and safety of cyclophosphamide in the treatment of patients with myasthenia gravis (MG) and thymoma.  Methods Ninety-five MG patients with thymoma were selected, and 60 of them were finally involved in the study. Patients were given low or median dose of cyclophosphamide (0.20 g intravenously per day, twice a week), and the dose was gradually increased to 0.80 g intravenously per week. When the total dose of cyclophosphamide reached 6 and 10 g, the drug efficacy was respectively assessed by Clinical Absolute Score (CAS) and Clinical Relative Score (CRS). Adverse events were also recorded. Results Compared with the score before treatment (19.65 ± 8.90), the CAS after 6 g (13.73 ± 8.63) and 10 g (10.58 ± 8.11) cyclophosphamide treatment were significantly lower than that of before treatment ( P < 0.05, for all). The drug efficacy of the treatment was 73.33% (44/60) and 81.67% (49/60) when the total dose reached 6 and 10 g, respectively. No serious adverse reactions occurred.  Conclusions Cyclophosphamide is an effective and safe treatment for post-thymectomized patients with myasthenia gravis and thymoma. Further follow-up and study is still needed to evaluate the long-term outcome. doi: 10.3969/j.issn.1672-6731.2014.10.010