No

Antineoplastic Agent, Alkylating Agent

Treat polycythemia vera; chronic myelocytic leukemia (in patients refractory to busulfan)

D

Pre-existing bone marrow suppression, hypersensitivity to any component

The U.S. Food and Drug Administration (FDA) currently recommends that procedures for proper handling and disposal of antineoplastic agents be considered; bone marrow suppression may not occur for 4 weeks

1% to 10%:

Gastrointestinal: Vomiting, diarrhea, nausea, abdominal cramps

Hematologic: Leukopenia, thrombocytopenia, anemia

Symptoms of overdose include severe marrow suppression

Supportive therapy is required

An alkylating agent considered to be cell-cycle nonspecific and capable of killing tumor cells in any phase of the cell cycle. Alkylating agents form covalent cross-links with DNA thereby resulting in cytotoxic, mutagenic, and carcinogenic effects. The end result of the alkylation process results in the misreading of the DNA code and the inhibition of DNA, RNA, and protein synthesis in rapidly proliferating tumor cells.

Children >15 years and Adults: Oral:

Myelocytic leukemia: 1.5-2.5 mg/kg/day until WBC drops to 10,000/mm³ then start maintenance 7-175 mg/day; stop if WBC falls to <3000/mm³ or platelets fall to <150,000/mm³

CBC, liver and renal function tests

None reported

May cause leukopenia; avoid clozapine or carbamazepine

No information available to require special precautions

No effects or complications reported

Notify physician if nausea, vomiting, diarrhea, or rash become severe or if unusual bleeding or bruising, sore throat, or fatigue occur; contraceptives are recommended during therapy

Monitor CBC, liver and kidney function tests

Tablet: 25 mg

Boivin P, "Indications, Procedure, and Results for the Treatment of Polycythaemia Vera by Bleeding, Pipobroman, and Hydroxyurea," Nouv Rev Fr Hematol, 1993, 35(5):491-8.

Brusamolino E, Canevari A, Salvaneschi L, et al, "Efficacy Trial of Pipobroman in Essential Thrombocythemia: A Study of 24 Patients," Cancer Treat Rep, 1984, 68(11):1339-42.

Brusamolino E, Salvaneschi L, Canevari A, et al, "Efficacy Trial of Pipobroman in Polycythemia Vera and Incidence of Acute Leukemia," J Clin Oncol, 1984, 2(6):558-61.

Chistolini A, Mazzucconi MG, Ferrari A, et al, "Essential Thrombocythemia: A Retrospective Study on the Clinical Course of 100 Patients," Haematologica, 1990, 75(6):537-40.

"Evaluation of Two Antineoplastic Agents, Pipobroman (Vercyte®) and Thioguanine," JAMA, 1967, 200(7):619-20.

Jeffrey LP, Chairman, National Study Commission on Cytotoxic Exposure. Position Statement. "The Handling of Cytotoxic Agents by Women Who Are Pregnant, Attempting to Conceive, or Breast-Feeding," January 12, 1987.

Mazzucconi MG, Francesconi M, Chistolini A, et al, "Pipobroman Therapy of Essential Thrombocythemia," Scand J Hematol, 1986, 37(4):306-9.