Alkylating agents thrombocytopenia

Carboplatin -atypical alkylating agent leading to DNA strand breakage during replication -bone marrow suppression—particularly thrombocytopenia -nausea and vomiting -liver function test abnormalities -uncommon neurotoxicity, ototoxicity... 

All are powerful alkylating agents. The development of Mitozolomide was progressed by May and Baker in Britain. Although it showed clinical activity and a marked advantage over Dacarbazine in crossing the blood-brain barrier, its development was terminated when it was found to cause severe thrombocytopenia (decrease of the blood platelet count). 

Mitomycin is an alkylating agent that is used intravenously to treat upper gastrointestinal and breast cancers and by direct instillation to treat superficial bladder tumors. Its main adverse effects are thrombocytopenia and leukopenia. Rare but severe adverse effects are hemolytic-uremic syndrome, pneumonitis, and cardiac failure. 

Direct vesicant effects, which can occur with active alkylating agents, can damage tissue at the site of injection as well as cause systemic toxicity. Toxic side effects of thiotepa include nausea, vomiting, fever, anorexia, headache, neutropenia, thrombocytopenia, and variable anemia. Although allergic reactions are rare, hives and skin rashes are occasionally noted. Other side effects include myelosup-pression and to a lesser extent, mucositis. Cardiac dysrhythmias and hypotension as well as pulmonary edema or pneumonitis may also occur. Toxicity is... 

Because sulfur and nitrogen mustards are alkylating agents, large exposures can cause bone marrow suppression, similar to that seen with radiation exposure (8). A drop in the absolute lymphocyte count, particnlarly within the first 12-24h after exposnre, may reflect impending bone marrow snppression (3). Leukopenia develops 3-5 days after exposnres, followed by thrombocytopenia and anemia (24,25). 

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