SIDE EFFECTS OF ALKYLATING AGENTS

Alkylating agents have many side effects that may include; 

·         Bone marrow suppression, including granulocytopenia, thrombocytopenia, anemia, or a combined loss of formed elements of the blood.

·         Associated increased risk for infections due to decreased host resistance

·         Nausea & vomiting

·         Some degree of GI toxicity, reversible hair loss (alopecia)

·         Secondary malignancies - increased risk following their use (they have most frequently been in the urinary bladder, myeloproliferative, or lymphoproliferative malignancies)

Drug Resistance to alkylating Agents

Cancer cells can acquire a resistance to alkylating agents by at least 3 mechanisms.

a)      increased ability to repair DNA lesions

b)      decreased permeability to the alkylating drug

c)       increased production of glutathione or increased glutathione S-transferase which catalyzes the conjugation of the drug to gluathione

ANTIMETABOLITES

  leukemia, cytotoxic drugs

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