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Chlorambucil
⚠️ Patient Safety Alert: Patients on chlorambucil should seek urgent medical advice if their temperature rises above 37.5°C (99.5°F) or 38°C (100.4°F), or if they feel unwell (e.g. chills, sore throat, cough, diarrhoea, urinary frequency). 👉 Even minor infections can escalate rapidly due to myelosuppression.
💊 About
- Chlorambucil is an oral alkylating agent used mainly in haematological malignancies.
- Causes DNA cross-linking and strand breaks, preventing replication and triggering apoptosis.
- Always check the BNF entry before prescribing.
⚙️ Mode of Action
- Binds covalently to DNA bases → causes cross-links and mispairing.
- Cell cycle non-specific but preferentially affects rapidly dividing cells.
🎯 Indications / Dose
- Dosing is specialist-led and given orally.
- Hodgkin’s disease.
- Non-Hodgkin’s lymphoma (selected types).
- Chronic lymphocytic leukaemia (CLL).
- Waldenström’s macroglobulinaemia.
🤝 Interactions
- See BNF for full details.
- Other myelosuppressive or immunosuppressive drugs increase toxicity risk.
⚠️ Cautions
- Oral anti-cancer medicines carry a high risk of dosing errors → doses must be double-checked.
- Monitor full blood counts closely.
- Carcinogenic potential with long-term use (risk of secondary malignancies).
🚫 Contraindications
- Refer to BNF for full list.
- Severe bone marrow suppression and active infection are key contraindications.
❗ Side Effects
- Common: Anaemia, neutropenia, thrombocytopenia, nausea, vomiting, diarrhoea, oral ulcers.
- Serious: Stevens–Johnson syndrome, infertility, seizures, secondary malignancies.
- Long-term: risk of myelodysplastic syndrome or acute leukaemia.
📚 References
| The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms. |
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