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Platinum Compounds

  1. CIsplatin
  2. Carboplatin
  3. Oxaliplatin
    1. MAO: same as alkylating agent
    2. Radiomimetic
    3. Radiation recall occurs
    4. Secondary tumors occur  

1. CisplatinMC used

Given as IV infusion

  1. DOC
    1. Ca Cervix
    2. Ca Overy
    3. Ca testis
    4. Also used in
      1. Ca Head & neck
      2. Ca (small cell lung)
      3. Ca bladder
      4. Ca esophagus
      5. Ca stomach

2. Carboplatin

  1. Safer alternative

3. Oxaliplatin

  1. Colorectal Ca
    1. Refractory
    2. Neurotoxic drug

S/E

4. MC

  1. Nausea
  2. Vomiting
  3. Neuropathy
  4. Bone marrow depression
  5. Ototoxicity
  6. Nephrotoxicity
  7. Nephrotoxicity
    1. Renal tubular acidosis
    2. Hyperkalemia
    3. Glomerlonephritis
    4. Proteiuria
       
      Rx-Mannitol

Secondary leukemias 

Most common type of secondary leukemia caused by anticancer drugs is AML(M3) type.

 

Drugs causing secondary tumors:

  1. Procarbazine
    1. Alkylating agent                            
    2. MAO Inhibitor      
    3. Disulfiram like reaction also occurs                
    4. Inhibits synthesis of DNA, RNA, proteins
    5. Part of MOPP                        
    6. Use: Hodgkin’s lymphoma 
  2. Epiodophylotoxins
    1. Etoposide
    2. Teniposide       
       
      i. Leads to seconadary leukemia Earliest (1-3 years) among all anticancer drugs,also known as early leukomegenic drugs 
  3. Platinum compounds
    1. Delayed leukemia
    2. 10-20% patients
       
      i. After 10-20 years of use
  4. Cyclophosphamide is least likely





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