Pronunciation guide

Chlorambucil is used for the treatment of Hodgkin's disease, certain forms of non-Hodgkin's lymphoma (NHL), chronic lymphocytic leukaemia (CLL) and ovarian cancer. It is used as palliative treatment which can make the lymphoma appear to go away for many years.

Chlorambucil is used in low-grade lymphoma, CLL and multiple myeloma. It can also be given to elderly patients with ovarian cancer who are unable to tolerate more aggressive therapy.

Is it effective?

Hodgkin's Disease

Patients with advanced Hodgkin's disease who were treated with chlorambucil in combination with vincristrine, procarbazine and prednisolone were found to respond just as well to treatment as patients who received mustine, vincristrine, procarbazine and prednisolone – one of the standard treatments for the disease. ¹

Non-Hodgkin's lymphoma (NHL)

Chlorambucil is effective in the treatment of high grade NHL when used in combination with other drugs in patients whose disease has relapsed. ² It has also been used for many years on its own for the treatment of low-grade NHL. There is evidence that increasing the dose may produce better results in terms of response rates and overall survival ³

Chronic lymphocytic leukaemia (CLL)

Chlorambucil has been the standard treatment for CLL for many years and remains the treatment of choice for this disease. ⁴

Ovarian cancer

Chlorambucil is one of the older drugs used to treat ovarian cancer and is sometimes used in elderly patients who cannot tolerate more aggressive therapy. ⁵

How is it taken?

• The tablets should be swallowed whole with plenty of water
• The tablets should be stored in the fridge

You should not take chlorambucil if: ⁶

• You are hypersensitive to any of the components of the tablets
• You are breastfeeding

How does it work?

• After the tablet is swallowed, chlorambucil passes from the gut into the bloodstream
• The bloodstream carries chlorambucil to the liver
• Here, it is converted into an active substance
• This active substance is taken to the cancer cells via the blood
• In the cancer cells, it is thought that the active substance binds in between the two strands of the genetic material, which means that the cells cannot divide

What are the side effects associated with chlorambucil? ⁸

The most common side effects associated with chlorambucil are:

• Temporary or prolonged increased susceptibility to infection, due to a reduction in the number of white blood cells
• Nausea and vomiting
• Feelings of indigestion

The information in this section is taken from published literature and the summary of product characteristics for this drug. For further patient information on chlorambucil please click on the UK Patient Information leaflet http://emc.medicines.org.uk/ and type in the word chlorambucil in the ‘quick search’ option box. Please contact your healthcare professional for full information on product availability in your country.

References

1. Hancock BW, Vaughn Hudson V, Vaughn Hudson B et al. British National Lymphoma Investigation randomised study MOPP (mustine, Oncovin, procarbazine, prednisolone) against LOPP (Leukeran substituted for mustine) in advanced Hodgkin's disease – long term results. British Journal of Cancer 1991; 63(4): 579-82.
2. Haaak HL, Wijermans PW, Kerkhofs H. Mitixantrone, teniposide, chlorambucil and prednisone (MVLP) for relapsed non-Hodgkin's lymphoma. The impact of advanced age and performance status. The Netherlands Journal of Medicine 1993; 42(3-4): 122-7.
3. Summerfield GP, Taylor PR, Mounter JP, et al. High-dose chlorambucil for the treatment of chronic lymphocytic leukaemia and low-grade non-Hodgkin's lymphoma. British Journal of Haematology 2002; 116:781-786.
4. Hamblin TJ. Achieving outcomes in chronic lymphocytic leukaemia. Drugs 2110; 61(5): 593-611.
5. Price P, Sikora K eds. Treatment of Cancer. Arnold, London, 2002.
6. Chlorambucil Summary of Product Characteristics. http://emc.medicines.org.uk/emc/assets/c/html/ displayDocPrinterFriendly.asp?documentid=2474
7. Cancerhelp UK http://www.cancerhelp.org.uk/help/default.asp?page=4103
8. CancerBACUP http://www.cancerbacup.org.uk/Treatments/Chemotherapy/ Individualchemotherapydrugs/Chlorambucil