Which medications in the drug class Antineoplastics, Alkylating are used in the treatment of Waldenstrom Macroglobulinemia?

Updated: Feb 01, 2021
  • Author: Karen Seiter, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Antineoplastics, Alkylating

These agents inhibit cell growth and proliferation. Many combinations of chemotherapeutic agents have been tried, with no evidence of clear superiority over single-agent chemotherapy with chlorambucil and considerably more toxicity.

Chlorambucil (Leukeran)

This agent alkylates and cross-links strands of deoxyribonucleic acid (DNA), inhibiting DNA replication and ribonucleic acid (RNA) transcription. Chlorambucil is an important drug in the treatment of Waldenström macroglobulinemia. It is usually administered when extreme bone marrow infiltration, anemia, splenomegaly, lymphadenopathy, and bleeding are present.

Melphalan (Alkeran)

Melphalan inhibits mitosis by cross-linking DNA strands; it ultimately disrupts nucleic acid function.


Cyclophosphamide is chemically related to nitrogen mustards. As an alkylating agent, the mechanism of action of the active metabolites may involve cross-linking of DNA, which may interfere with the growth of normal and neoplastic cells.

Bendamustine (Bendeka)

Alkylating agent that cross-links single or double DNA strands resulting in DNA breakdown; cell cycle-nonspecific

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