What is a common side effect associated with the chemotherapy agent Cyclophosphamide (Cytoxan)?

Hemorrhagic cystitis is a well-documented side effect of Cyclophosphamide (Cytoxan) due to the drug's metabolite, acrolein, which can irritate the bladder and lead to bleeding. This side effect occurs particularly at higher doses of Cyclophosphamide and is a result of the drug's effect on the urothelium (the lining of the bladder). To mitigate this risk, hydration is emphasized, and sometimes mesna, a protective agent, is co-administered to inactivate the metabolite in the urinary tract.

While the other options (ototoxicity, neuropathy, and cardiotoxicity) are associated with various chemotherapeutic agents or conditions, they are not common side effects of Cyclophosphamide. Ototoxicity is more often linked to drugs like cisplatin, neuropathy can arise with agents such as vincristine or paclitaxel, and cardiotoxicity is primarily associated with anthracyclines like doxorubicin.