Alkylating agents
Alkylating agents are drugs that yield an unstable alkyl group, R-CH2+, reacting with nucleophilic centers on proteins and nucleic acids. They can inhibit DNA replication and transcription.
Toxicity: Dose-limiting toxicity: myelosuppression (neutropenia nadir: 6 to 10 days with recovery in 14 to 21 days). Mucositis, nausea and vomiting, neurotoxicity, alopecia. Long-term toxicities: pulmonary fibrosis, infertility, secondary malignancies.