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Biotransformation of cyclophosphamide. The biotransformation of cyclophosphamide involves multiple drug-metabolizing enzymes that are subject to genetic polymorphism, which in turn may affect the disposition of cyclophosphamide and its metabolites. However, because of the fact that its metabolism is regulated by several phase I and phase II enzymes, a genetic defect in a single gene might go unnoticed because other metabolic enzymes may serve as escape metabolic routes.
