Also Known As: BCNU, BiCNU®
Late Effect (1st of 3)
- Decreased functioning of the ovaries in females or testes in males (hypogonadism)
- Infertility
- Early menopause
Your risk is greater if:
- You are female and were treated during puberty.
- You are male.
- It was combined with
- Other alkylating agents
- Testicular radiation
- Pelvic radiation
- Total body radiation
- Craniospinal radiation in girls
- Head and neck radiation
Recommended Evaluation
- History and physical exam, especially sexual history in males and menstrual history in females yearly
- Hormone levels (females - FSH, LH, estradiol; males - LH, FSH, testosterone), and semen analysis as indicated based on need
Management
- Because of the risk of early menopause, females should carefully weigh a decision to delay childbearing.
- You may need a referral to a reproductive endocrinologist for fertility concerns. Sometimes, recovery of fertility occurs spontaneously many years after treatment.
- Your doctor may recommend a bone mineral density to see if you have osteopenia or osteoporosis.
- You may benefit from hormone replacement therapy; discuss it with your doctor.
Late Effect (2nd of 3)
Acute myeloid leukemia (AML)
Your risk is greater if:
- It has been less than 10 years since you finished treatment. (It is more common in first 10 years.)
- You received a high cumulative dose or if you also received an alkylating agent, especially melphalan or mechlorethamine.
Recommended Evaluation
- Physical exam yearly
- Complete blood count and differential yearly for up to 15 years
- Evaluation of symptoms of fatigue, pallor, petechiae (small red rash), and bone pain
- Bone marrow evaluation if indicated
Management
- You will need to see a medical or pediatric oncologist for treatment if you develop AML.
Late Effect (3rd of 3)
Pulmonary fibrosis (loss of elasticity in the lungs leading to progressive difficulty breathing)
Your risk is greater if:
- You received 600 mg/m² or more.
- You also received other therapy toxic to the lungs (e.g., bleomycin, cyclophosphamide, radiation to the chest or spine).
- You smoke cigarettes.
Recommended Evaluation
- Physical exam yearly
- Pulmonary function tests at the end of treatment, then every 2-3 years and as indicated
Management
- DO NOT SMOKE.
- Do aerobic exercise regularly to improve stamina and endurance.
- You may need to have a consultation with a pulmonologist (doctor specializing in the breathing problems), especially if symptoms develop.
- Have a flu vaccination each year.
