Carmustin

Last updated on: 29.10.2020

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Definition
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Carmustine, also known as BCNU, is a cytostatically active drug (molecular formula C5H9Cl2N3O2) from the group of nitrosoureas, which is used in the treatment of certain severe, advanced tumour diseases. Carmustine, like the nitrogen-lost derivatives and the related nitrosourea lomustine, contains chloroethyl residues and additionally a highly reactive nitroso group.

The carmustine molecules decompose spontaneously and release the alkylating ethyl carbonium ion, which causes cross-linking of the DNA by alkylation of guanine and cytosine.

In addition, isocyanates are formed, which also inhibit DNA repair by combining with the DNA polymerase. Carmustin and lomustin have a phase-independent effect, i.e. they also act on resting cells.

Indication
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Treatment of brain tumours (carmustine, like lomustine, is a liquid: glioblastoma, brainstem glioma, medulloblastoma, astrocytoma and ependymoma, brain metastases) as well as the second therapy for non-Hodgkin lymphomas and Hodgkin's disease.

Undesirable effects
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Severe, reversible delayed onset myelosuppression with thrombocytopenia.

Carmustine is toxic to the lungs (interstitial pneumonia, pulmonary fibrosis)

Note(s)
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Because of its strong side effects Carmustin is used only in a very limited way. However, carmustine is considered irreplaceable for the preparation of patients for stem cell transplantation.

Literature
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  1. Graefe KH et al. non-selective cytotoxic chemotherapeutics (cytostatics) In: Graefe KH et al (Eds) Pharmacology and Toxicology. Georg Thieme Publisher Stuttgart S 667

Last updated on: 29.10.2020