Common brand names

• Leukeran

How it is administered

Chlorambucil is administered orally in the form of film-coated tablets. Each tablet contains 2 mg of chlorambucil. The usual dosage for adults with chronic lymphocytic leukemia is 0.1 to 0.2 mg per kilogram of body weight daily for 3 to 6 weeks as required. The entire daily dose can be taken at one time. Dosage must be carefully adjusted according to the patient's response and blood counts.

How it works

Chlorambucil is a type of chemotherapy medication known as an alkylating agent. It works by interfering with the DNA replication process in cancer cells. Specifically, chlorambucil binds to DNA and causes cross-linking of DNA strands, which prevents the cells from dividing and growing. This action triggers a process called apoptosis, or programmed cell death, particularly in rapidly dividing cells like cancer cells.

In chronic lymphocytic leukemia (CLL), chlorambucil helps reduce the number of abnormal white blood cells, which can improve symptoms and slow the progression of the disease. The medication is not curative but can provide useful palliation and help manage the disease.

Who should take it

Chlorambucil is indicated for the treatment of chronic lymphocytic leukemia (CLL), as well as certain types of malignant lymphomas, including lymphosarcoma, giant follicular lymphoma, and Hodgkin’s disease. It is used when the disease is active and requires treatment, particularly in patients who may not tolerate more aggressive therapies.

Patients with CLL who need to lower their lymphocyte counts or control symptoms related to the disease may benefit from chlorambucil. The medication is typically prescribed under the supervision of a hematologist or oncologist who will monitor blood counts and adjust the dose as needed.

Who should not take it

Chlorambucil should not be used in patients whose disease has shown prior resistance to the drug. It is also contraindicated in patients who have demonstrated hypersensitivity or allergic reactions to chlorambucil. There may be cross-hypersensitivity with other alkylating agents, so caution is needed if you have had allergic reactions to similar medications.

Additionally, chlorambucil should not be used in patients with conditions other than chronic lymphocytic leukemia or malignant lymphomas due to its carcinogenic properties. Women who are pregnant or may become pregnant should avoid this medication, as it can cause harm to the developing fetus. Patients should not receive live vaccines while on this medication due to immunosuppression.

Commonly used with

Chlorambucil may be used alone or in combination with other medications for blood cancers, depending on the treatment plan. In some cases, it is used with corticosteroids or other chemotherapy agents to enhance its effectiveness or manage side effects. The choice of combination depends on the specific type of blood cancer and the patient's overall health.

Commonly tested with

Chlorambucil has been tested in combination with other chemotherapeutic agents and, in some cases, with radiation therapy for the treatment of chronic lymphocytic leukemia and lymphomas. Alternate dosing schedules, such as intermittent or pulse dosing, have also been studied to optimize effectiveness and reduce toxicity. The medication is also sometimes tested with supportive care agents to manage side effects.