Cyclophosphamide-induced splenic toxicity: a mini-review

Cyclophosphamide is a chemotherapeutic and immunosuppressive agent, widely used all over the world. However, it causes severe splenic toxicity. This review is a summary of experiments which show that cyclophosphamide can lead to spleen weight loss, decreased splenic cellularity, lower number of lymphocyte population, and disorganizing of red and white pulp areas of the spleen. Moreover, lymphoid depletion, loss of pulp demarcation, sinusoidal dilation, congestion, and hemosiderin deposition as histopathological changes are frequently reported by authors. Besides, this review points out the immunological impacts, such as a decrease in the humoral as well as cellular immune responses. Most importantly, a number of natural products and antioxidants have demonstrated the ability to protect and restore the immunity when used in the treatment of cyclophosphamide-induced splenic damage. In general, the results of the studies show that the spleen is one of the main organs affected by cyclophosphamide, and encourage the use of protective therapies alongside treatments.