関: melphalan

WordNet

antineoplastic drug (trade name Alkeran) used to treat multiple myeloma and some other malignancies (同)Alkeran
the 16th letter of the Roman alphabet (同)p
the 12th letter of the Roman alphabet (同)l

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personal assistant個人秘書 / public address [system]
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phosphorusの化学記号
lira(イタリアの貨幣単位リラ)
liter[s]

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/07/25 16:18:36」(JST)

wiki en

Melphalan (trade name Alkeran, in former USSR also known as Sarcolysin) is a chemotherapy drug belonging to the class of nitrogen mustard alkylating agents.

An alkylating agent adds an alkyl group (C_nH_2n+1) to DNA. It attaches the alkyl group to the guanine base of DNA, at the number 7 nitrogen atom of the imidazole ring.

Otherwise known as L-Phenylalanine Mustard, or L-PAM, melphalan is a phenylalanine derivative of mechlorethamine.

Mechanism of action

Melphalan chemically alters through alkylation of the DNA nucleotide guanine, and causes linkages between strands of DNA. This chemical alteration inhibits DNA synthesis and RNA synthesis, functions necessary for cells to survive. These changes cause cytotoxicity in both dividing and non-dividing tumor cells.^[1]

Uses

It is used to treat multiple myeloma,^[2] ovarian cancer, AL amyloidosis, and occasionally malignant melanoma.

The agent was first investigated as a possible drug for use in melanoma. It was not found to be effective, but has been found to be effective in the treatment of myeloma.

Melphalan is currently being used to treat ocular retinoblastoma, a pediatric solid tumor. This is accomplished via transarterial catheter based slow pulsed infusion into the ophthalmic artery.^[3]

Administration

Oral or intravenous; dosing varies by purpose and route of administration as well as patient weight.

Melphalan Prescribing Information: Alkeran^[4]

Melphalan Patient Information: MedlinePlus^[5]

Melphalan Material Safety Data Sheet (MSDS): Sequoia Research Products^[6]

Side effects

Common side effects include:

Nausea and vomiting, and oral ulceration.
Bone marrow suppression, including
- Decreased white blood cell count causing increased risk of infection
- Decreased platelet count causing increased risk of bleeding

Less common side effects include:

Severe allergic reactions
Pulmonary fibrosis (scarring of lung tissue) including fatal outcomes (usually only with prolonged use)
Hair loss
Interstitial pneumonitis
Rash
Itching
Irreversible bone marrow failure due to melphalan not being withdrawn early enough.
Cardiac arrest.

References

^ "Melphalan". National Cancer Institute. Retrieved 4 August 2014.
^ Facon T, Mary JY, Hulin C et al. (October 2007). "Melphalan and prednisone plus thalidomide versus melphalan and prednisone alone or reduced-intensity autologous stem cell transplantation in elderly patients with multiple myeloma (IFM 99-06): a randomised trial". Lancet 370 (9594): 1209–18. doi:10.1016/S0140-6736(07)61537-2. PMID 17920916.
^ Gobin YP, Dunkel IJ, Marr BP et al. (Jun 2011). "Intra-arterial chemotherapy for the management of retinoblastoma: four-year experience". Arch Ophthalmol 129 (6): 732–7. doi:10.1001/archophthalmol.2011.5. PMID 21320950.
^ celgene.com
^ nlm.nih.gov
^ seqchem.com

UpToDate Contents

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1. 成人における抗癌剤の投与 dosing of anticancer agents in adults
2. 資源の乏しい状況での多発性骨髄腫のマネージメント management of multiple myeloma in resource poor settings
3. 多発性骨髄腫の治療プロトコル treatment protocols for multiple myeloma
4. 多発性骨髄腫における自家造血細胞移植 autologous hematopoietic cell transplantation in multiple myeloma
5. 再発性または難治性多発性骨髄腫の治療 treatment of relapsed or refractory multiple myeloma

English Journal

Persistence of retinal function after intravitreal melphalan injection for retinoblastoma.

Brodie SE, Munier FL, Francis JH, Marr B, Gobin YP, Abramson DH.SourceDepartment of Ophthalmic Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA, scott.brodie@mssm.edu.
Documenta ophthalmologica. Advances in ophthalmology.Doc Ophthalmol.2013 Feb;126(1):79-84. doi: 10.1007/s10633-012-9358-6. Epub 2012 Nov 11.
BACKGROUND: The risk/benefit profile of intravitreal melphalan injection for treatment of active vitreous seeds in retinoblastoma remains uncertain. We report clinical and electroretinography results after 6 months of one patient who has shown a favorable initial clinical response to intravitreal m
PMID 23143758

Stem cell transplantation after reduced intensity conditioning for sickle cell disease.

Matthes-Martin S, Lawitschka A, Fritsch G, Lion T, Grimm B, Breuer S, Boztug H, Karlhuber S, Holter W, Peters C, Minkov M.SourceSt. Anna Children's Hospital, Department of Paediatrics, Medical University, Vienna, Austria.
European journal of haematology.Eur J Haematol.2013 Feb 1. doi: 10.1111/ejh.12082. [Epub ahead of print]
Sickle cell disease (SCD) is still associated with substantial morbidity and reduced life expectancy. Disease related mortality rises to 14% in adolescents and young adults. Overall and disease free survival following haematopoietic stem cell transplantation (HSCT) is 90% and 95% respectively. In or
PMID 23369103

Age at menopause and its influencing factors in a cohort of survivors of childhood cancer: earlier but rarely premature.

Thomas-Teinturier C, El Fayech C, Oberlin O, Pacquement H, Haddy N, Labbé M, Veres C, Guibout C, Diallo I, De Vathaire F.SourceRadiation Epidemiology Group, Center for Research in Epidemiology and Population Health (CESP) - INSERM U1018, Villejuif F-94800, France.
Human reproduction (Oxford, England).Hum Reprod.2013 Feb;28(2):488-95. doi: 10.1093/humrep/des391. Epub 2012 Nov 15.
STUDY QUESTION: Is the age at menopause in a cohort of childhood cancer survivors earlier and what are the risk factors associated with earlier age at menopause SUMMARY ANSWER: Menopause occurred at a median age of 44 years in this cohort which is earlier than in the general population, but prem
PMID 23154067

Japanese Journal

骨髄移植後にB型劇症肝炎を発症した急性骨髄性白血病の一例

菊池裕二,尾崎勝俊,松山智洋,岡智子,山本千鶴,森政樹,永井正,室井一男,小澤敬也
自治医科大学紀要 33, 111-116, 2011-03-01
悪性リンパ腫に対する自家末梢血幹細胞移植後に二次性白血病を発症した40歳男性に対し,非血縁男性ドナーから同種骨髄移植を行った。移植前,患者はHBsAg(-), HBsAb(-), HBcAb(-), HCVAb(+), HCV-RNA(+)であった。移植後より肝機能障害が遷延し,移植片対宿主病(graft-versus-host disease; GVHD)が疑われたためタクロリムス(tacrol …
NAID 110008506960

ドキソルビシン,メルファランおよびメトトレキサートの抗腫瘍効果に影響する食品の検討

岩本祥子,須永克佳,原田園子 [他]
日本栄養・食糧学会誌 64(6), 393-401, 2011
… 本実験では俗に悪性腫瘍に有効とされ, がんの化学療法を受けている患者が積極的に摂取する可能性がある8種の食品やハーブの酢酸エチル抽出物を被検試料として, 化学療法薬であるドキソルビシン (DOX), メルファラン (L-PAM) およびメトトレキサート (MTX) と相互作用を引き起こす可能性について検討した。 …
NAID 40019167962

ドキソルビシン, メルファランおよびメトトレキサートの抗腫瘍効果に影響する食品の検討

岩本祥子,須永克佳,原田園子,大久保温子,津田整
日本栄養・食糧学会誌 64(6), 393-401, 2011
… (L-PAM) およびメトトレキサート …
NAID 130002129286

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★リンクテーブル★

リンク元	「メルファラン」「L-フェニルアラニンマスタード」
関連記事	「PAM」「PA」「L」「P」

「メルファラン」

Melphalan
Systematic (IUPAC) name
	4-[bis(chloroethyl)amino]phenylalanine
Clinical data
Trade names	Alkeran
AHFS/Drugs.com	monograph
MedlinePlus	a682220
Legal status	℞ (Prescription only);
Routes of; administration	Oral, intravenous
Pharmacokinetic data
Bioavailability	25% to 89%
Metabolism	hydrolysis
Biological half-life	1.5 ± 0.8 hours
Excretion	Renal, significantly metabolised
Identifiers
CAS Registry Number	148-82-3
ATC code	L01AA03
PubChem	CID: 4053
IUPHAR/BPS	7620
DrugBank	DB01042
ChemSpider	405297
UNII	Q41OR9510P
KEGG	D00369
ChEBI	CHEBI:28876
ChEMBL	CHEMBL852
Synonyms	2-amino-3-[4-[bis(2-chloroethyl)amino]phenyl]-propanoic acid
Chemical data
Formula	C13H18Cl2N2O2
Molecular mass	305.2 g/mol
	SMILES c1cc(ccc1C[C@@H](C(=O)O)N)N(CCCl)CCCl ;
	InChI InChI=1S/C13H18Cl2N2O2/c14-5-7-17(8-6-15)11-3-1-10(2-4-11)9-12(16)13(18)19/h1-4,12H,5-9,16H2,(H,18,19)/t12-/m0/s1 ; Key:SGDBTWWWUNNDEQ-LBPRGKRZSA-N ;
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