Cutaneous Reaction to Chlorambucil Therapy

Abstract

<h3>To the Editor.—</h3> Chlorambucil is an oral nitrogen mustard derivative used primarily to treat chronic lymphocytic leukemia, non-Hodgkin's lymphomas, certain carcinomas,¹and connective tissue diseases.²The major side effects are dose-related bone marrow depression and gastrointestinal tract symptoms such as anorexia, nausea, and vomiting.³There are several reports of a possible teratogenic effect and neurotoxic manifestations including convulsions and coma.¹In addition, continuous chlorambucil therapy has been shown to induce neoplasia as a result of cumulative chromosomal damage.²Allergic skin reactions to chlorambucil therapy are rare. Two cases of chlorambucil-related skin reactions have been reported in patients with chronic lymphocytic leukemia.^1,3We describe a patient with nodular histiocytic lymphoma who had a similar type of skin reaction secondary to chlorambucil therapy. <h3>Report of a Case.—</h3> A previously healthy 61-year-old woman was diagnosed to have stage IV, poorly differentiated, nodular, histiocytic lymphoma in July 1984.