II. Indications
- FDA Approved (replaced by newer agents for these indications)
- Breast Adenocarcinoma
- Ovarian Adenocarcinoma
- Bladder Superficial Papillary Carcinoma
- Hematopoetic Stem Cell Transplant (combined with other agents for pediatric class 3 Beta Thalassemia)
- Off-Label
- Hematopoetic Stem Cell Transplant (for CNS neoplasms)
- Leptomeningeal Metastases (administered via intrathecal route)
- Lymphoma
III. Mechanism
-
Aziridine alkylating Antineoplastic Agent
- Derived from triethylenephosphoramide (TEPA)
- Prodrug that metabolizes in vivo to active ethylenimine groups
- Ethylenimine groups bind DNA at guanine's N7 position
- Cross-links DNA, blocks cell growth and division
IV. Medications
- Lypholized powder for injection: 15 mg, 100 mg
V. Dosing
- See other references for disease specific dosing protocols
VI. Adverse Effects
- Alopecia
- Bone Marrow Suppression
- Secondary Malignancy
- Impaired future fertility
VII. Safety
- Avoid in Lactation
- Avoid in Pregnancy (all trimesters)
- Use reliable Contraception
- Monitoring