Which of the following chemotherapeutic agents is associated with secondary leukemia?
Cisplatin belongs to the group of medicines known as alkylating agents. It is used to treat cancer of the bladder, ovaries, and testicles. It is a platinum coordination complex that is hydrolysed intracellularly to produce a highly reactive moiety which causes cross linking ofDNA. Theoured siteis N&;ofguanineresidue. It can also react with -SH groups in proteins and has radiomimetic propey. It is bound to plasma proteins, enters tissues and is slowly excreted unchanged in urine with a tlh about 72 hrs. Negligible amounts enter brain.Leukemia is cancer of the body&;s blood-forming tissues, including the bone marrow and the lymphatic system. Alkylating agents are chemo drugs that interfere with a cell's DNA in a ceain way. These drugs can sometimes cause AML and MDS. Often MDS develops first, which then progresses to AML. The chemo drugs cisplatin and carboplatin are not an alkylating agents, but they attack cancer cells in much the same way. These drugs seem to increase the risk of leukemia (mainly AML), too, but the risk is not as great as with the alkylating agents. This leukemia is hard to treat and tends to have a poor outcome, much like the leukemia linked to the alkylating agents. The risk of leukemia rises as the amount of drug used gets higher. The risk of developing leukemia increases even more if radiation is given along with cisplatin or carboplatin. REFERENCE:ESSENTIALS OF MEDICAL PHARMACOLOGY(K.D.TRIPATHI,SIXTH EDITION,PAGE NO:827) www.mayoclinic.org
Vinblastine
Paclitaxel
Cisplatin
Bleomycin
Chemotherapy