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Related Experiment Videos

Chlorambucil-induced seizures

E Salloum1, K K Khan, D L Cooper

  • 1Department of Internal Medicine, Yale University School of Medicine, Yale Cancer Center, New Haven, Connecticut 06520, USA.

Cancer
|March 1, 1997
PubMed
Summary
This summary is machine-generated.

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Chlorambucil can cause seizures, particularly in children with nephrotic syndrome and adults receiving high doses. Patients with a history of seizures may be more susceptible even at lower chlorambucil doses.

Area of Science:

  • Oncology
  • Neurology
  • Pharmacology

Background:

  • Anecdotal reports of chlorambucil-induced seizures exist, primarily in non-oncologic literature.
  • Seizures are more common with high-dose chlorambucil therapy and in pediatric patients with nephrotic syndrome.
  • Oncologists and hematologists may be unaware of this rare but serious complication.

Purpose of the Study:

  • To investigate the incidence and characteristics of chlorambucil-induced seizures.
  • To identify patient populations at higher risk for this adverse event.

Main Methods:

  • Case presentation of two elderly patients experiencing seizures post-chlorambucil initiation.
  • MEDLINE search to identify and review previously reported cases of chlorambucil-induced seizures.

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  • Analysis of underlying diseases, treatment regimens, and patient demographics in reported cases.

    • Main Results:

    • Twenty-eight previously reported cases plus the two new cases total 30 instances of chlorambucil-induced seizures.
    • Nephrotic syndrome (12 cases) and solid tumors (10 cases) were common underlying conditions.
    • Pediatric patients (16/30) and those receiving high-dose therapy or accidental overdose were frequently affected. Recurrent seizures occurred upon rechallenge.

    Conclusions:

    • Children with nephrotic syndrome may have increased sensitivity or altered pharmacokinetics leading to higher seizure incidence.
    • In adults without a seizure history, high-dose chlorambucil is associated with seizures.
    • Adults with a prior seizure history may experience seizures even with lower chlorambucil doses, suggesting alternative therapies may be safer.