Introduction
Leukeran is used in the treatment of some cancers of blood and lymphatic system. It may be also used to treat other kinds of cancer, as determined by the doctor. It is used alone or in combination with other cancer medicines.
Leukeran should be taken empty stomach, or 1 hour before and 2 hours after a meal. But, try to have it at the same time every day for most benefits. This will depend on what you are being treated for and may change from time to time. You should take it exactly as your doctor has advised. Taking it in the wrong way or taking too much can cause very serious side effects. It may take several weeks or months for you to see or feel the benefits but do not stop taking it unless your doctor tells you to.
The most common side effects of this medicine include anemia (low number of red blood cells), decreased blood cells (red cells, white cells, and platelets) decreased white blood cell count, infection, nausea and vomiting. If these bother you or appear serious, let your doctor know. There may be ways of reducing or preventing them.
Inform your doctor if you have a medical history, of bleeding disorders, heart or liver disease, radiation treatment or any infection. Many other medicines can affect, or be affected by, this medicine so let your doctor know all medications you are using. This medicine is known to reduce the number of blood cells in your blood thereby, increasing the susceptibility to infections. Regular blood tests are required to check your blood cells along with kidney, liver and heart function during treatment with this medicine. The use of effective contraception by both males and females during treatment is important to avoid pregnancy.
Uses of Leukeran
- Blood cancer
- Hodgkin’s disease
Side effects of Leukeran
Common
- Anemia (low number of red blood cells)
- Decreased blood cells (red cells, white cells, and platelets)
- Decreased white blood cell count (neutrophils)
- Decreased white blood cell count
- Bone marrow suppression
- Nausea
- Vomiting
- Diarrhea
- Mouth ulcer
How to use Leukeran
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Leukeran is to be taken empty stomach.
How Leukeran works
Leukeran is an anti-cancer medication. It works by damaging the genetic material (DNA and RNA) of the cancer cells. This stops their growth and multiplication.
What if you forget to take Leukeran?
If you miss a dose of Leukeran, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.
Indication
Lymphocytic leukemia, non-Hodgkin lymphoma, Waldenstrm macroglobulinemia, polycythemia vera, trophoblastic neoplasms, ovarian carcinoma, nephrotic syndrome, Hodgkin's disease
Administration
Should be taken on an empty stomach. Take on an empty stomach. Ensure adequate hydration. Swallow whole, do not chew/crush.
Adult Dose
Chronic Lymphatic (Lymphocytic) Leukemia
0.1 mg/kg/day for 3-6 weeks or
0.4 mg/kg (increased by 0.1 mg/kg/dose until response/toxicity observed) biweekly or
0.4 mg/kg (increased by 0.1 mg/kg/dose until response observed) monthly or
0.03-0.1 mg/kg/day continuously
Reduce initial dose if administered within 4 weeks after a full course of radiation/myelosuppressive therapy or patients with bone marrow disease
Not to exceed 0.1 mg/kg/day if bone marrow infiltrated with lymphocytes
Hodgkin's Lymphoma
0.2 mg/kg/day for 3-6 weeks or
0.4 mg/kg (increased by 0.1 mg/kg/dose until response/toxicity observed) biweekly or
0.4 mg/kg (increased by 0.1 mg/kg/dose until response or toxicity observed) monthly or
0.03-0.1 mg/kg/day continuously
Reduce initial dose if administered within 4 weeks after a full course of radiation/myelosuppressive therapy or patients with bone marrow disease
Not to exceed 0.1 mg/kg/day if bone marrow infiltrated with lymphocytes
Hepatic Impairment
Primarily metabolized in liver; dose reduction may be required
Renal Dose
Renal Impairment
<1% (including metabolites) excreted in urine; no dose adjustment required
Contraindication
Hypersensitivity. Pregnancy and lactation. Porphyria.
Mode of Action
Chlorambucil interferes with DNA replication and RNA transcription by alkylation and cross-linking cellular DNA strands, thus leading to disruption of the nucleic acid function.
Precaution
Renal or hepatic dysfunction. Perform blood counts regularly. Seizure disorder, bone marrow suppression. Patient who has received radiation therapy, myelosuppressive drugs or has a depressed baseline leukocyte/platelet count within the previous 4 wk. Increased incidence of acute leukaemias and other secondary malignancies.
Lactation: not known if excreted in breast milk; do not nurse
Side Effect
>10%
Neutropenia (25-33%),Anemia,Leukopenia,Thrombocytopenia
Frequency Not Defined
Seizures,Hallucinations,Peripheral neuropathy,Nausea,Vomiting,Pulmonary fibrosis,GI effects,Leukemia,Myelosuppression,Hyperuricemia,Infertility,Hepatotoxicity & jaundice,Type I hypersensitivity,Rash,Stevens-Johnson syndrome (rare),Toxic epidermal necrosis (rare),Urticaria,Erythema multiforme (rare),Secondary malignancies
Potentially Fatal: Severe bone marrow suppression, carcinogenic and human infertility.
Pregnancy Category Note
Pregnancy Category: D
Lactation: not known if excreted in breast milk; do not nurse
Interaction
Impairs immune response to vaccines, possible infection after admin of live vaccines.