Association with malignant lymphoma

The hypothesis that phenoxy herbicides are a cause of soft tissue sarcoma (STS) also commenced in Sweden. Three case-control studies conducted by the same investigators reported relative risks of 3.3 to 5.7 for such an association (Table V) (42-44 ). However, as with malignant lymphoma, it is difficult to explain such dramatic risks associated with short term exposures. Moreover, Wiklund and Holm (45) found no overall risk increase from STS among Swedish agriculture and forestry workers (RR—0.9 95% Cl 0.8-1.0). 

Renal function impairment Renal failure or dialysis patients may require smaller doses closely supervise to prevent cardiac failure or exacerbation of renal failure. Carcinogenesis Dietary administration of minoxidil to mice for up to 2 years was associated with an increased incidence of malignant lymphomas in females at all dose levels (10, 25, and 63 mg/kg/day) and an increased incidence of hepatic nodules in males (63 mg/kg/day). 

The principal advantage of MMF over alternative systemic immunosuppressive agents (e.g., methotrexate, cyclosporine) is its relative lack of hepatotoxicity and nephrotoxicity. Adverse effects produced by MMF most commonly include nausea, abdominal cramps, diarrhea, and possibly an increased incidence of viral and bacterial infections. Whether MMF may be associated with an increased long-term risk of lymphoma or other malignancies is controversial however, any such risk is likely to be lower in patients treated for skin disease with MMF monotherapy than in transplant patients treated with combination immunosuppressive therapy. 

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