Paclitaxel bone-marrow suppression

Paclitaxel Bone marrow suppression, peripheral neuropathy, alopecia... 

Taxanes (paclitaxel, docetaxel) are derivatives of yew tree bark (Taxus brevifolia). They stabilize microtubules in the polymerized state leading to nonfunctional microtubular bundles in the cell. Inhibition occurs during G2- and M-phases. Taxanes are also radiosensitizers. Unwanted effects include bone marrow suppression and cumulative neurotoxicity. 

Paclitaxel -natural taxane inhibits depolymerization of tubulin in mitotic spindle apparatus -bone marrow suppression -nausea and vomiting—mild -mucocutaneous effects (mucositis, stomatitis, diarrhea) -hypersensitivity reactions -peripheral neuropathy -myalgias, arthralgias -mild vesicant... 

Bone marrow suppression is a dose-limiting adverse effect often encountered with paclitaxel. Neutropenia occurs most commonly 8-10 days after treatment, and recovery usually occurs on days 15-21. Paclitaxel is relatively platelet-sparing, and thrombocytopenia and anemia are rare (26). There is no evidence that neutropenia is cumulative, suggesting that paclitaxel may not irreversibly damage hemopoietic stem cells (1). 

Adverse effects of paclitaxel and docetaxel are similar, being hypersensitivity reactions, bone marrow suppression, peripheral neuropathy, hair loss and cardiac arrhythmias. 

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