Background: Cyclophosphamide (CP) is an important anticancer drug which belongs to the class of alkylating agents. CP is mostly used in bone marrow transplantation, rheumatoid arthritis, lupus erythematosus, multiple sclerosis, neuroblastoma and other types of cancer. CP was approved by Food and Drug Administration (FDA) for treatment of breast cancer, retinoblastoma, minimal change nephrotic syndrome in pediatric patients and ovarian adenocarcinomas. CP is used in the management of autoimmune illnesses like multiple sclerosis due to its potent immunosuppressive properties and prior to organ transplantation to reduce the risk of transplantation rejection