Oncology
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss in Understanding Medical Terms, 2020
Chemotherapy has become increasingly effective in treating cancer, especially leukemia and lymphoma. It is used in advanced stages of many cancers, often as an adjunct to surgery and/or radiation therapy. A number of metastatic cancers are now considered curable by chemotherapeutic regimens. The approximately fifty drugs that have been used to destroy or retard the growth of cancer cells are categorized as alkylating agents, which prevent cell division by disrupting DNAalkaloidsantimetabolites, agents that impair cell metabolismantitumor antibiotics that disrupt synthesis of RNAendocrine or hormonal agentsimmunologic stimulants
Ocular and adnexal tumours
Pat Price, Karol Sikora in Treatment of Cancer, 2014
The late morbidity of patients with orbital RMS treated by chemoradiotherapy has been studied well by Heyn et al.47 The incidence of acute non-lymphocytic leukaemia following alkylating agent–containing chemotherapy is approximately 4%,48 and there will be a small incidence of other second tumours following chemoradiation. Following radiotherapy to the orbit, there is always some retardation of growth, which is inversely related to age; cataract; and a substantial incidence of dry-eye syndrome with photophobia and keratoconjunctivitis. Where the hypothalamus has received the majority of the radiation dose, clinically important deficits in growth hormone secretion have been demonstrated. Particularly in boys, the alkylating agent in chemotherapy may lead to infertility.
Chemotherapy in pregnancy
Hung N. Winn, Frank A. Chervenak, Roberto Romero in Clinical Maternal-Fetal Medicine Online, 2021
Alkylating agents include the subclass of nitrogen mustards, of which the compounds in most common use today include cyclophosphamide, ifosfamide, and melphalan, and chlorambucil. To exhibit their antineoplastic properties, many of these agents, such as cyclophosphamide, must be converted to an active metabolite in the liver. The compounds then attach to the alkyl groups in DNA, causing cross-linking between double-helix strands and preventing the uncoiling of DNA that is necessary for replication. Alkylating agents are used in several different tumor types including, but not limited to, breast cancer, NHL, chronic lymphocytic leukemia, ovarian cancer, bone and soft-tissue sarcomas, and rhabdomyosarcomas.
Anticancer therapy and lung injury: molecular mechanisms
Published in Expert Review of Anticancer Therapy, 2018
Li Li, Henry Mok, Pavan Jhaveri, Mark D Bonnen, Andrew G Sikora, N. Tony Eissa, Ritsuko U Komaki, Yohannes T Ghebre
Alkylating antineoplastic agents are a class of chemotherapeutic drugs that recognize and directly interact with DNA by transferring their alkyl group to the DNA base. Alkylating agents are very effective in treating several cancer types including hematologic malignancies, breast cancer, and lung cancer. Examples of alkylating antineoplastic agents include nitrogen mustards (e.g. cyclophosphamide, chlorambucil), nitrosureas (e.g. carmustine, streptozocin), hydrazines (procarbazine, temozolomide), alkyl sulfonates (e.g. busulfan), and metal salts (cisplatin, carboplatin). Preclinical studies and case reports indicate that these agents have significant adverse effects including causing lung toxicity that extends from acute pneumonitis to late-onset pneumonitis that progresses into fibrosis [17].
Treatment of classical Hodgkin’s lymphoma in children and adolescents
Published in Expert Opinion on Pharmacotherapy, 2019
David Gómez-Almaguer, Oscar González-Llano, Valentine Jiménez-Antolinez, Andrés Gómez-De León
Another important side effect of treatment is infertility, the use of alkylating agents is related to gonadal dysfunction including azoospermia in male patients and premature ovarian failure in women [59]. A study of GHSG assessing fertility in female patients after being treated with trials HD7 to HD9, showed that at 3.2 years of follow up, 51% of patients receiving eight cycles of dose-escalated BEACOPP present amenorrhea [60]. When comparing ABVD and BEACOPP in female fertility, amenorrhea is more common in the latter; despite this fact a recent single-center study showed that there is no significant difference between females treated with ABVD or BEACOPP in achieving pregnancy [61]. The American Society of Clinical Oncology updated in 2018 the guidelines for fertility preservation in children and adults with cancer. For postpubertal children options include semen or oocyte cryopreservation but for prepubertal children ovarian or testicular cryopreservation are still in investigation [62].
The safety of current pharmacotherapeutic strategies for osteosarcoma
Published in Expert Opinion on Drug Safety, 2021
Mariella Spalato, Antoine Italiano
The effects of CDDP and IFO have also been studied in other settings. Regarding CDDP, data concerning female fertility are limited[170]. Conversely, much more information is available on male infertility due to the strong interest in assessing the risk in patients affected by testicular cancers. Although the results cannot be exactly comparable to other oncological settings due to a predisposition for infertility in testicular cancer patients, the risk does not appear to be negligible and is dose-related. Indeed, 36% of male patients with normal pre-treatment sperm production developed oligospermia or azoospermia after a CDDP-based regimen; in particular, gonadic dysfunction affects 19% of patients receiving a cumulative dose of 400 mg/m2, increasing to 47% if the cumulative dose is 600 mg/m2[171]. Alkylating agents increase the risk of infertility in both male and female patients, with males showing a higher susceptibility [172,173].