Melphalan (Alkeran)
General information
Class/mechanism: Nitrogen mustard, alkylator. Melphalan is a bischloroethylamine alkylating agent that crosslinks DNA by binding at the N7 position of guanine, with activity against resting and proliferating cells.[1][2]
Route: IV, PO
Extravasation: irritant or neutral, depending on reference
For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias such as Micromedex, Lexicomp, UpToDate (courtesy of Lexicomp), or the prescribing information.[1]
Diseases for which it is established (work in progress)
Diseases for which it is used
- Acute myeloid leukemia
- Acute promyelocytic leukemia
- Ewing sarcoma
- Classical Hodgkin lymphoma
- Neuroblastoma
- Non-Hodgkin lymphoma
- Plasma cell dyscrasia
Diseases for which it was used
Patient drug information
- Melphalan (Alkeran) patient drug information (Chemocare)[3]
- Melphalan (Alkeran) patient drug information (UpToDate)[4]
History of changes in FDA indication
- 1964-01-17: Initial FDA approval[5]
- Uncertain date: Indicated for the palliative treatment of multiple myeloma. (Based on SWG01)
- Uncertain date: Indicated for the palliation of non-resectable epithelial carcinoma of the ovary. (No supporting studies are cited)
History of changes in EMA indication
- 1963-09-26: EURD
Also known as
- Generic names: L-PAM, L-Sacrolysin, L-Sarcolysin, MPL, phenylalanine mustard
- Brand names: Alkeran, Alkerana, Evomela, Levofolan, Melfalan, Phelinun
References
- Drugs
- Intravenous medications
- Oral medications
- Irritant
- Neutral
- Alkylating agents
- Nitrogen mustards
- Acute myeloid leukemia medications
- Acute promyelocytic leukemia medications
- CNS lymphoma medications
- Diffuse large B-cell lymphoma medications
- Ewing sarcoma medications
- Follicular lymphoma medications
- HIV-associated lymphoma medications
- Classical Hodgkin lymphoma medications
- Light-chain (AL) amyloidosis medications
- Mantle cell lymphoma medications
- Multiple myeloma medications
- Neuroblastoma medications
- Peripheral T-cell lymphoma medications
- Plasma cell leukemia medications
- Breast cancer medications (historic)
- Ovarian cancer medications (historic)
- FDA approved in 1964
- EMA approved in 1963
- WHO Essential Cancer Medicine