II. Indications
- FDA Approved
- Off-label
- Mantle Cell Lymphoma
- Multiple Myeloma
- B-Cell Non-Hodgkin Lymphoma
- Waldenstrom Macroglobulinemia
III. Mechanism
- See Alkylating Agent
- Nitrogen Mustard derived antineoplastic Alkylating Agent
-
Mechlorethamine derivative with alkylator and antimetabolite properties
- Alkylating group (cross-links DNA)
- Purine Analogue (DNA, RNA and Protein synthesis inhibitor)
- Vesicant
IV. Medications
- Treanda 25 mg and 100 mg vials containing powder for preparation of IV solution
- Bendeka 100 mg/4 ml IV solution
V. Dosing
- See other references for disease specific dosing protocols
VI. Pharmacokinetics
- Hepatic metabolism to both active and inactive metabolites
VII. Safety
- Avoid in Lactation
- Avoid in pregnancy (contraindicated in all trimesters)
- Teratogenic and adverse outcomes
- Use reliable Contraception
- Monitoring
VIII. Adverse Effects
- Bone Marrow Suppression
- Nephrotoxicity
- Hepatotoxicity
- Hypersensitivity and Drug Reactions