Lymphoma drug, chlorambucil tablets Indications: Hodgkin's disease, several types of non-Hodgkin's lymphoma, chronic lymphoma leukemia, Waldenstrom's macroglobulinemia, in advanced ovarian adenocarcinoma. However, for the remaining part of breast cancer patients may have a significant effect.
Chlorambucil tablets Dosage:
Hodgkin disease: drug therapy as a single standard dose of 0.2 mg / kg body weight / day, continuing for 4 to 8 weeks. However, leave can often combined with other anticancer drugs, and several different prescriptions. The drug also can be used as nitrogen mustard nitrogen mustard in lieu of medication, it is more toxic effects of nitrogen mustard small, but the effects are similar.
Non-Hodgkin's lymphoma : a single-drug treatment, starting dose of 0.1 to 0.2 mg / kg body weight / day, continuous treatment of 4-8 weeks; maintenance treatment can reduce the daily dose or intermittent treatment. However, leave can be used for the treatment of disseminated and late recurrence after radiotherapy of lymphoblastic lymphoma. For advanced non-Hodgkin lymphoblastic lymphoma, chlorambucil alone treatment and no significant difference between combination chemotherapy.
Chronic lymphocytic leukemia: when patients have obvious symptoms or have been proved by the peripheral blood indicates damage to bone marrow (not bone marrow failure) can then leave when the treatment began. Left to natural starting dose of 0.15 mg / kg body weight / day until the total number of white blood cells dropped to 10,000 / L (mcl). The first four weeks after the end of treatment can be treated again, a dose of 0.1 mg / kg body weight / day.
Lymphoma in some patients after drug treatment for about two years, the number of leukocytes in the blood can be reduced to the normal range, increased the spleen and lymph nodes than palpation, and the proportion of lymphocytes in the bone marrow to 20% less. Patients with bone marrow failure if the performance should be first treated with prednisolone, prednisolone, wait until after the performance of bone marrow regeneration can be started leaving then. Intermittent therapy compared with the daily drug treatment showed that the two treatment groups in efficacy and side effects were no significant differences in frequency.
Waldenstrom's macroglobulin leukemia: stay to the treatment drug of choice However, the recommended starting dose of 6-12 mg / day until leukopenia, later reduced to 2 to 8 mg dose / day, depending on treatment time with disease.
Ovarian cancer: a single drug treatment standard of 0.2 mg / kg body weight / day, 4 to 6 weeks. Can also use the 0.3 mg / kg body weight / day until leukopenia. Maintenance dose of 0.2 mg / kg body weight / day, and the white blood cells could be maintained at 4,000 / cubic millimeter or less. Practical application, maintenance medication treatment for 2-4 weeks between each treatment separated by 2 to 6 weeks.
Advanced breast cancer: single-drug standard of 0.2 mg / kg body weight / day, medication for 6 weeks. However, leave can be used in combination with prednisolone, prednisolone, the dosage is 14 to 20 mg / day, no need to consider body weight: If no serious inhibition of hematopoietic function, treatment time can be more than 4 to 6 weeks. However, you can leave by 5 to 7.5 mm / square meter body surface area / day dose methotrexate methotrexate, 5 – fluorouracil 5-fluorouracil and prednisolone prednisolone combination.
Chlorambucil tablets contraindications: In view of indications of a serious condition, it is therefore not an absolute contraindication.
Note:
However, leave can be a strong cytotoxic drugs, only under the guidance of experienced doctors before medication. No defects in the outer layer tablets without risk, but not natural pills can be split to stay.
Monitoring: Because then you can stay can cause irreversible bone marrow damage during treatment, blood counts should be monitored closely.
However, the therapeutic dose can remain the main inhibitory lymphocytes, and neutrophils, platelets and hemoglobin is less important. Beginning in the fall when the neutrophils can not stay then, but have to bear in mind that the decline in neutrophils after stopping still for 10 days or longer. Recently had received radiation therapy and other Cytotoxic drug treatment of patients should not use the stay can be natural. When bone marrow or bone marrow aplasia lymphocyte infiltration situation, the daily dose should not exceed 0.1 mg / kg body too.
Patients with impaired renal function: increased bone marrow suppression as azotemia, medication monitoring should pay more attention on.
Patients with impaired liver function: to stay natural metabolism can still study, for obviously have liver dysfunction, the dosage should be reduced.
Lymphoma drug, mutation and carcinogenic effects: Chlorambucil can cause male chromatid or chromosome damage. Acid has been reported that application of nitrogen mustard treatment of benzene chronic lymphocytic leukemia acute leukemia after. However, it remains unclear Zhezhong acute leukemia is the natural course of disease or chemotherapy Bixu Suozhi. To accept and not accept the alkylating agents for the treatment of ovarian cancer, the results showed that the patients included chlorambucil alkylation agent significantly increased after the incidence of acute leukemia. Long term use of chlorambucil for the treatment of breast cancer patients with a small number of bone marrow cells of leukemia occurred, so when using chlorambucil treatment should weigh the risk and lead to leukemia.