“…Cy itself is inactive and must first undergo metabolic activation, catalyzed by the hepatic cytochrome P450 to 4-hydroxy-cyclophosphamide and later to phosphoramide mustard and acrolein. The mustard component produces a cytotoxic effect by preventing cell replication, while acrolein is linked with its toxic side effects (Sun and Peng, 2008). Toxicities of Cy include the suppression of white blood cells, nausea, vomiting, gonadal atrophy, liver, renal, and bladder injury.…”