Alkylating agents lymphomas

To translate this approach into clinical scenarios, the risk-benefit assessment of chemotherapy administration in already immunocompromised patients would favor situations in which cytotoxic drugs are indicated anyhow, such as in AIDS-related lymphomas, where alkylating agents are part of the standard regimens. 

Lomustine is an orally available nitrosurea alkylating agent. Lomustine is converted rapidly to the cis- and frans-4-hydroxy metabolites the range of half-lives of these two metabolites is 2 to 4 hours.25 Lomustine has shown clinical activity in the treatment of Hodgkin s lymphoma and melanoma. Side effects are similar to those of carmustine. Patients should receive only enough drug for one cycle at a time to prevent confusion and accidental overdose. 

Alkylating agents Chlorambucil Murine thymoma, Murine lymphoma. Melanoma... 

The alkylating agents can be considered to be cell-cycle independent drugs. They are used for the management of leukemias, lymphomas, multiple myeloma and some carcinoma s and soft tissue tumors, generally as components of drug combination regimens. Cyclophosphamide is also used for its marked immunosuppressant properties. 

Uracil mustard or uramustine is an alkylating agents that is used in lymphatic malignancies such as non-Hodgkin s lymphoma. Chemically it is a derivative of nitrogen mustard and uracil. It is preferentially taken up in cancer cells that need uracil to make nucleic acids during their rapid cycles of cell division. 

Mechlorethamine Mustargen) is a cytotoxic alkylating agent. Topical application of freshly prepared aqueous solutions are used in patients with early stages of cutaneous T-cell lymphoma. A major disadvantage to the use of this drug is the rapid induction of allergic contact dermatitis in some patients. 

The drug is highly active in the treatment of chronic lymphocytic leukemia, with approximately 40% of patients achieving remissions after previous therapy with alkylating agents has failed. Activity is also seen in the low-grade lymphomas. 

Nitrogen mustards, as anticancer alkylating agents, were first tested on experimental lymphoma in mice and the results were sufficiently encouraging to warrant a therapeutic trial in man. The response of fhe first patient was as dramatic as that of the first mouse, following 10 days treatment. But severe bone marrow damage occurred and, disappointingly, as the bone marrow recovered so did the tumour in addition, with further courses, the tumour rapidly became resistant. 

Ifosfamide is an alkylating agent belonging to the group of oxazaphosphorines. It is used to treat a variety of solid tumors in children, including rhabdomyosarcoma, soft tissue sarcomas, Wilms tumor, bone sarcomas, and neuroblastoma, and leukemias and lymphomas in adults. It is also sometimes used in combination with other drugs, such as doxorubicin or cisplatin and etoposide. 

Melphalan (L-phenylalanine mustard) is an alkylating agent that has been used to treat a wide variety of solid malignancies, including cancers of the breast and ovary, and multiple myeloma. Intravenous melphalan has been used to treat rhabdomyosarcoma, lymphomas, multiple myeloma, and neuroblastoma (1). 

Chlorambucil is an alkylating agent that retards or stops growth of cancer cells. It is used to treat chronic lymphocytic leukemia, malignant lymphomas such as lymphosarcoma, giant follicular lymphoma, ovarian cancer, and Hodgkin s disease. 

Cyclophosphamide, a nitrogen mustard alkylating agent, is a widely used cancer chemotherapeutic drug to treat lymphomas, leukemias, multiple myeloma and a numerous solid tumors. Cyclophosphamide can induce nephrotoxicity characterized as decreased water excretion and an inappropriate concentration of urine. These effects are due to a direct effect of one or more alkylating cyclophosphamide metabolites at distal tubules and collecting ducts. Special caution is warranted to avoid water-induced diuresis or diuretic therapy in these patients as hyponatremia can become a problem. 

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