Also Known As: Alkeran®
Late Effect (1st of 2)
- Decreased functioning of the ovaries in females or testes in males (hypogonadism)
- Infertility
- Early menopause
Your risk is greater if:
- You are male.
- You are female and were treated during or after puberty.
- It was combined with:
- Other alkylating agents.
- Radiation therapy to the testicles, pelvis, or total body.
- You received a high dose of the drug.
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 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 2)
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 other alkylating agents, especially mechlorethamine.
Recommended Evaluation
- Physical exam yearly
- Complete blood count and differential yearly
- Evaluation of symptoms of fatigue, pallor, petechiae (small red rash), and bone pain
- A bone marrow exam if you have any symptoms.
Management
- You will be referred to a medical or pediatric oncologist for treatment if you are diagnosed with AML.
