Melphalan: Chemotherapy drugs list & full guide
Melphalan is a potent alkylating cytostatic agent derived from nitrogen mustard. It functions by binding to the DNA of cancer cells and causing cross-links within the DNA strands, effectively preventing cell division and leading to tumor cell death.
It remains the "gold standard" in treatment protocols for multiple myeloma and is widely used in high-dose conditioning regimens prior to stem cell transplantation. On Unifarm, you can find a comprehensive list of medications (both tablets and injectables) containing Melphalan.
Indications
- Multiple Myeloma: As monotherapy or in combination with prednisone/thalidomide.
- Advanced Ovarian Cancer: Specifically for epithelial carcinoma.
- Polycythemia Vera: To suppress excessive blood cell production.
- Neuroblastoma in children (as part of high-dose chemotherapy).
- Regional arterial perfusion for malignant melanoma of the extremities and soft tissue sarcoma.
Dosage and administration
Available as oral tablets and lyophilized powder for injection. Dosing is strictly individualized based on body weight and blood counts.
Typical Regimens:
- Oral (Tablets): For myeloma, the standard dose is 0.15 mg/kg body weight daily for 4 days. Cycles are repeated every 6 weeks.
- Intravenous: Administered via infusion. High-dose therapy may range from 140–200 mg/m² body surface area (requires hydration).
Oral doses should be taken on an empty stomach, as food significantly reduces absorption.
- Hypersensitivity to Melphalan.
- Breastfeeding period.
- Severe bone marrow suppression (leukopenia, thrombocytopenia), unless caused by the disease being treated.
- Administration of live vaccines during therapy.
Therapy requires weekly blood monitoring due to toxicity:
- Hematologic: Myelosuppression (low white blood cells and platelets) is the most common dose-limiting effect.
- Gastrointestinal: Nausea, vomiting, diarrhea, stomatitis (at high doses).
- Allergic reactions: Hives, edema, rarely anaphylaxis.
- Other: Alopecia (hair loss), secondary malignancies (leukemia) with prolonged use.
