Chlorambucil

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Chlorambucil
Systematic (IUPAC) name
4-[bis(2-chlorethyl)amino]benzenebutanoic acid
Identifiers
CAS number	305-03-3
ATC code	L01AA02
PubChem	2708
DrugBank	APRD00115
Chemical data
Formula	C14H19Cl2NO2
Mol. mass	304.212 g/mol
Pharmacokinetic data
Bioavailability	?
Metabolism	Hepatic
Half life	1.5 hours
Excretion	N/A
Therapeutic considerations
Pregnancy cat.	D(US)
Legal status	℞ Prescription only
Routes	Oral

Chlorambucil (marketed as Leukeran by GlaxoSmithKline) is a chemotherapy drug that has been mainly used in the treatment of chronic lymphocytic leukemia. It is a nitrogen mustard alkylating agent and can be given orally.

In the past, chlorambucil has been used for treating some types of non-Hodgkin lymphoma, Waldenström macroglobulinemia, polycythemia vera, trophoblastic neoplasms, and ovarian carcinoma. It also has been used as an immunosuppressive drug for various autoimmune and inflammatory conditions, such as nephrotic syndrome. Its current use is mainly in chronic lymphocytic leukemia, as it is well tolerated by most patients, though chlorambucil has been largely replaced by fludarabine as first-line treatment in younger patients.^[1]

[edit] Side Effects

Bone marrow suppression (anemia, neutropenia, thrombocytopenia) is the most commonly occurring side effect of chlorambucil. Withdrawn from the drug, this side effect is typically reversible. Like many alkylating agents, chlorambucil has been associated with the development of other forms of cancer.

Less commonly occurring side effects include:

• Gastrointestinal Distress (nausea, vomiting, diarrhea, and oral ulcerations).
• Central Nervous System: Seizures, tremors, muscular twitching, confusion, agitation, ataxia, and hallucinations.
• Skin reactions
• Hepatotoxicity
• Infertility

[edit] References

[edit] External links

• Leukeran (manufacturer's website)
• Chlorambucil (patient information)
• MedlinePlus's Drug Information

v • d • e Chemotherapeutic agents/Antineoplastic agents (L01) Alkylating and alkylating-like agents Nitrogen mustards: (Chlorambucil, Chlormethine, Cyclophosphamide, Ifosfamide, Melphalan, Bendamustine, Uramustine) Nitrosoureas:(Carmustine, Fotemustine, Lomustine, Streptozocin) Platinum (alkylating-like): (Carboplatin, Cisplatin, Oxaliplatin, Triplatin tetranitrate, Satraplatin) Alkyl sulfonates:(Busulfan, Treosulfan) Hydrazines:(Procarbazine, Dacarbazine, Temozolomide) Aziridines:(ThioTEPA) Antimetabolites Folic acid: (Aminopterin, Methotrexate, Pemetrexed, Raltitrexed) Purine: (Cladribine, Clofarabine, Fludarabine, Mercaptopurine, Pentostatin, Thioguanine) Pyrimidine: (Cytarabine, Decitabine, Fluorouracil/Capecitabine, Floxuridine, Gemcitabine) Spindle poison/mitotic inhibitor Taxane: (Docetaxel, Larotaxel, Paclitaxel). Vinca: (Vinblastine, Vincristine, Vindesine, Vinorelbine). Cytotoxic/antitumor antibiotics Anthracycline family: (Daunorubicin, Doxorubicin, Epirubicin, Idarubicin, Mitoxantrone, Pixantrone, Valrubicin) streptomyces (Actinomycin, Bleomycin, Mitomycin, Plicamycin) - Hydroxyurea Topoisomerase inhibitors Camptotheca: (Camptothecin, Topotecan, Irinotecan, Rubitecan), Podophyllum:(Etoposide, Teniposide) CI monoclonal antibodies Receptor tyrosine kinase (Cetuximab, Panitumumab, Trastuzumab) - CD20 (Rituximab, Tositumomab) - other (Alemtuzumab, Bevacizumab, Gemtuzumab) Photosensitizers Aminolevulinic acid, Methyl aminolevulinate, Porfimer sodium, Verteporfin Tyrosine kinase inhibitors Axitinib, Bosutinib, Cediranib, Dasatinib, Erlotinib, Gefitinib, Imatinib, Lapatinib, Lestaurtinib, Nilotinib, Semaxanib, Sorafenib, Sunitinib, Vandetanib Cyclin-dependent kinase inhibitor Seliciclib Other retinoids (Alitretinoin, Tretinoin), Fusion protein (Aflibercept) - Altretamine, Amsacrine, Anagrelide, Arsenic trioxide, Asparaginase (Pegaspargase), Bexarotene, Bortezomib, Celecoxib, Denileukin diftitox, Elesclomol, Estramustine, Irofulven, Ixabepilone, Masoprocol, Mitotane, Oblimersen, Testolactone, Tipifarnib, Trabectedin