Chlorambucil carcinogenicity

Bone marrow toxicity is the major side effect of chlorambucil. Nausea is uncommon or mUd, and hair loss does not occur. Chlorambucil shares the immunosuppressive, teratogenic, and carcinogenic properties of the nitrogen mustards. 

A known or probable human mutagen, chlorambucil has been shown to be teratogenic, mutagenic, and carcinogenic in experimental models. 

Chlorambucil is carcinogenic in experimental animals. When administered intraperitoneally to rats, lymphosarcomas, myelogenous leukemia, and reticulum cell sarcomas were noted. Mice receiving the material intraperitoneally developed lymphosarcomas, lung adenomas, and adenocarcinomas. Female mice developed ovarian neoplasms. 

Chlorambucil is known to be a human carcinogen based on sufficient evidence of carcinogenicity in humans. Leukemia was reported in a number of epidemiological studies in which chlorambucil was used as a chemotherapeutic agent either alone or in combination with other agents. The risk of developing cancer increases with increasing dose and time of treatment. 

Chlorambucil was used for refractory cases of sarcoidosis (6,299) with response rates similar to those reported with MTX. However, chlorambucil is carcinogenic and has been replaced by less toxic agents (300). 

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