Which medications in the drug class Antineoplastic agents are used in the treatment of Langerhans Cell Histiocytosis?

Updated: Jun 12, 2020
  • Author: Christopher R Shea, MD; Chief Editor: William D James, MD  more...
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Answer

Antineoplastic agents

These agents inhibit cell growth and proliferation.

Mechlorethamine (Mustargen)

Mechlorethamine forms interstrand and intrastrand cross-links in DNA, which, in turn, results in miscoding, breakage, and failure of replication, inhibiting cell growth. It is dispensed as either an aqueous solution or an ointment. The contents of a 10-mg vial are rehydrated with 50 mL of tap water. The patient should wear protective plastic gloves while applying the solution. Unused preparation may be stored in refrigerator.

Vinblastine (Alkaban-AQ, Velban)

Vinblastine inhibits microtubule formation, which, in turn, disrupts the formation of a mitotic spindle, causing cell proliferation to arrest at metaphase.

Etoposide (Toposar, VePesid)

Etoposide inhibits topoisomerase II and causes DNA strand breakage, causing cell proliferation to arrest in the late S or early G2 portion of the cell cycle.

Mercaptopurine (Purinethol)

Mercaptopurine is a purine analog that inhibits DNA and RNA synthesis, causing cell proliferation to arrest.

Methotrexate (Folex, Rheumatrex)

Methotrexate is an antimetabolite that inhibits DNA synthesis and cell reproduction in malignant cells. Adjust the dose gradually to attain a satisfactory response. Refer to individual protocols; it may be administered through various routes.

2-CdA/Cladribine (Leustatin)

2-CdA/cladribine is a synthetic antineoplastic agent for continuous intravenous infusion. The enzyme deoxycytidine kinase phosphorylates this compound into active 5+-triphosphate derivative, which, in turn, breaks DNA strands and inhibits DNA synthesis. It disrupts cell metabolism, causing death to resting and dividing cells.

Cytarabine (Cytosar-U, Tarabine PFS)

Cytarabine is converted intracellularly to the active compound cytarabine-5'-triphosphate, which inhibits DNA polymerase. It is cell-cycle S-phase specific. Cytarabine blocks the progression from G1 to the S phase and, in turn, kills cells that undergo DNA synthesis in the S phase of the cell proliferation cycle.

Vemurafenib (Zelboraf)

Vemurafenib is an inhibitor of some mutated forms of BRAF serine-threonine kinase, including BRAF-V600. It is indicated for Erdheim-Chester disease (ECD) with BRAF V600 mutation. This is the first FDA-approved treatment for ECD.


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