Generic drug: chlorambucil
Brand name: Leukeran
What is Leukeran (chlorambucil), and how does it work?
Leukeran belongs to a class of drugs called Antineoplastics, Alkylating.
It is not known if Leukeran is safe and effective in children.
What are the side effects of Leukeran?
Leukeran (chlorambucil) can severely suppress bone marrow function. Chlorambucil is a carcinogen in humans. Chlorambucil is probably mutagenic and teratogenic in humans. Chlorambucil produces human infertility.
Leukeran may cause serious side effects including:
- difficulty breathing,
- swelling of your face, lips, tongue, or throat,
- unusual mass or lump,
- severe vomiting or diarrhea,
- new or worsening cough,
- easy bruising,
- unusual bleeding (nose, mouth, vagina, or rectum),
- purple or red pinpoint spots under skin,
- upper stomach pain,
- loss of appetite,
- dark urine,
- clay-colored stools,
- yellowing of the skin or eyes (jaundice),
- swollen gums,
- painful mouth sores,
- pain when swallowing,
- skin sores,
- cold or flu symptoms,
- trouble breathing,
- sore throat,
- skin pain, and
- a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling
Get medical help right away, if you have any of the symptoms listed above.
The most common side effects of Leukeran include:
Tell the doctor if you have any side effect that bothers you or that does not go away.
These are not all the possible side effects of Leukeran. For more information, ask your doctor or pharmacist.
What is the dosage for Leukeran?
- The usual oral dosage is 0.1 to 0.2 mg/kg body weight daily for 3 to 6 weeks as required. This usually amounts to 4 to 10 mg per day for the average patient.
- The entire daily dose may be given at one time. These dosages are for initiation of therapy or for short courses of treatment.
- The dosage must be carefully adjusted according to the response of the patient and must be reduced as soon as there is an abrupt fall in the white blood cell count.
- Patients with Hodgkin’s disease usually require 0.2 mg/kg daily, whereas patients with other lymphomas or chronic lymphocytic leukemia usually require only 0.1 mg/kg daily.
- When lymphocytic infiltration of the bone marrow is present, or when the bone marrow is hypoplastic, the daily dose should not exceed 0.1 mg/kg (about 6 mg for the average patient).
- Alternate schedules for the treatment of chronic lymphocytic leukemia employing intermittent, biweekly, or oncemonthly pulse doses of chlorambucil have been reported.
- Intermittent schedules of chlorambucil begin with an initial single dose of 0.4 mg/kg.
- Doses are generally increased by 0.1 mg/kg until control of lymphocytosis or toxicity is observed. Subsequent doses are modified to produce mild hematologic toxicity.
- It is felt that the response rate of chronic lymphocytic leukemia to the biweekly or once-monthly schedule of chlorambucil administration is similar or better to that previously reported with daily administration and that hematologic toxicity was less than or equal to that encountered in studies using daily chlorambucil.
- Radiation and cytotoxic drugs render the bone marrow more vulnerable to damage, and chlorambucil should be used with particular caution within 4 weeks of a full course of radiation therapy or chemotherapy. However, small doses of palliative radiation over isolated foci remote from the bone marrow will not usually depress the neutrophil and platelet count. In these cases chlorambucil may be given in the customary dosage.
- It is presently felt that short courses of treatment are safer than continuous maintenance therapy, although both methods have been effective.
- It must be recognized that continuous therapy may give the appearance of “maintenance” in patients who are actually in remission and have no immediate need for further drug.
- If maintenance dosage is used, it should not exceed 0.1 mg/kg daily and may well be as low as 0.03 mg/kg daily. A typical maintenance dose is 2 mg to 4 mg daily, or less, depending on the status of the blood counts. It may, therefore, be desirable to withdraw the drug after maximal control has been achieved, since intermittent therapy reinstituted at time of relapse may be as effective as continuous treatment.
- Procedures for proper handling and disposal of anticancer drugs should be used. Several guidelines on this subject have been published.1-4 There is no general agreement that all of the procedures recommended in the guidelines are necessary or appropriate.
- Patients with hepatic impairment should be closely monitored for toxicity.
- As chlorambucil is primarily metabolized in the liver, dose reduction may be considered in patients with hepatic impairment when treated with LEUKERAN.
- However, there are insufficient data in patients with hepatic impairment to provide a specific dosing recommendation.
What drugs interact with Leukeran?
Is Leukeran safe to use while pregnant or breastfeeding?
- Chlorambucil can cause fetal harm when administered to a pregnant woman.
- Unilateral renal agenesis has been observed in 2 offspring whose mothers received chlorambucil during the first trimester.
- It is not known whether this drug is excreted in human milk.
- Because many drugs are excreted in human milk and because of the potential for serious adverse reactions in nursing infants from chlorambucil, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
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Leukeran (chlorambucil) is a prescription medicine used to treat the symptoms of Chronic Lymphatic (Lymphocytic) Leukemia and Hodgkin’s Lymphoma. Leukeran may be used alone or with other medications. Serious side effects of Leukeran include hives, difficulty breathing, swelling of your face, lips, tongue, or throat, seizures, unusual mass or lump, severe vomiting or diarrhea, new or worsening cough, easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under skin, and others.
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Related Disease Conditions
Leukemia is a type of cancer of the blood cells in which the growth and development of the blood cells are abnormal. Strictly speaking, leukemia should refer only to cancer of the white blood cells (the leukocytes) but in practice, it can apply to malignancy of any cellular element in the blood or bone marrow, as in red cell leukemia (erythroleukemia).
What Is the Life Expectancy of a Person With Leukemia?
Leukemia is a group of cancers of the blood affecting the white blood cells. White blood cells are the infection-fighting cells of the body. In adults, leukemia is most common in people older than 55 years, with the average age of diagnosis being 66 years. It is also one of the most common cancers in children and adults younger than 20 years. The survival rate is higher for younger people.
How Does Leukemia Kill?
Leukemia is a cancer of the white blood cells of the bone marrow. Patients with leukemia have an over-production of a particular blood cell type in the body, the white blood cells (cells that fight infection, and provide immunity).
What Is Non-Hodgkin's Lymphoma?
Non-Hodgkin's lymphoma (NHL) is cancer of the lymphatic system, a vital part of the body's immune system. Symptoms include swollen lymph nodes, fever, night sweats, coughing, weakness, chest pain, unexplained weight loss, and abdominal pain.
Can Lymphoma Be Completely Cured?
Lymphomas are considered to be a treatable form of cancer if detected early. The overall 5-year survival rate for non-Hodgkin lymphoma (NHL) is 62%, whereas the 5-year survival rate for Hodgkin lymphoma is 92% if detected early.
Mantle Cell Lymphoma (MCL)
Mantle cell lymphoma (MCL) is a rare form of non-Hodgkin's lymphoma. It is not known what causes MCL. MCL signs and symptoms include fever, enlarged spleen and liver, fatigue, and weight loss. Treatment of MCL incorporates radiotherapy and chemotherapy. MCL has a poor prognosis as it typically is diagnosed in a late stage.
What Is Burkitt Lymphoma?
There are multiple types of Burkitt lymphoma. Burkitt lymphomas are types of non-Hodgkin's lymphoma that affect the bone marrow and central nervous system. Symptoms of Burkitt lymphoma may include nausea, vomiting, headache, fatigue, enlarged lymph nodes, and many other symptoms. Diagnosis involves lab testing, imaging studies, patient history, and cytogenic evaluation. There are multiple staging systems used to stage Burkitt lymphoma. Treatment consists of chemotherapy. The prognosis tends to be more favorable in children than in adults.
Survival Rate for Acute Lymphoblastic Leukemia
The prognosis depends on the type of leukemia, the extent of the disease, age of the patient, and the general condition of the patient. Some patients can go into complete remission. The average five-year survival rate of leukemia is 60-65%.
Hodgkin's vs. Non-Hodgkin's Lymphoma
Both Hodgkin's disease (sometimes referred to as Hodgkin's lymphoma) and non-Hodgkin's lymphoma are cancers that originate in a type of white blood cell known as a lymphocyte, an important component of the body's immune system.
What Is the Main Cause of Primary Lymphoma of Bone?
Primary lymphoma of bone (PLB) is a rare type of cancer that starts in the bone instead of the lymph nodes. PLB accounts for less than 5% of all bone tumors. PLB is also known as reticulum cell sarcoma, malignant lymphoma of bone or osteolymphoma, and it is a type of non-Hodgkin’s lymphoma. Pain is the most common symptom of PLB.
How Bad Is Lymphoma Cancer Of Bone?
Lymphoma is a cancer of infection-fighting cells (lymphocytes), white blood cells of the immune system. These cells are normally found in the lymph nodes, spleen, thymus, and bone marrow.
Leukemia: Signs, Symptoms, And Complications
Leukemia results when the genetic material (DNA) of a single cell in the bone marrow transforms, this is called a mutation. A mutated cell does not perform body function, but it eats away the nutrition meant for the normal cells.
How Do You Get Non-Hodgkin’s Lymphoma?
Non-Hodgkin lymphoma (NHL) is cancer that affects the lymphatic system, a part of the body’s immune system. The lymphatic system helps in filtering foreign cells and microorganisms. The lymphatic system is comprised of lymph fluid, lymph nodes, tonsils, thymus, and the spleen.
What Are the Stages of Chronic Lymphocytic Leukemia?
Chronic lymphocytic leukemia is a cancer of the blood and bone marrow. With this type of cancer, the marrow creates too many abnormal lymphocytes. There are five stages of chronic lymphocytic leukemia.
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You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.