Leukeran Special Precautions

Immunisation using a live organism vaccine has the potential to cause infection in immunocompromised hosts. Therefore, immunisations with live organism vaccines are not recommended.
Patients who will potentially have autologous stem cell transplantation should not be treated with LEUKERAN long term.
Safe handling of LEUKERAN Tablets: See Instructions for Use/Handling under Cautions for Usage.
Monitoring: Since LEUKERAN is capable of producing irreversible bone marrow suppression, blood counts should be closely monitored in patients under treatment. At therapeutic dosage LEUKERAN depresses lymphocytes and has less effect on neutrophil and platelet counts and on haemoglobin levels. Discontinuation of LEUKERAN is not necessary at the first sign of a fall in neutrophils but it must be remembered that the fall may continue for 10 days or more after the last dose.
LEUKERAN should not be given to patients who have recently undergone radiotherapy or received other cytotoxic agents.
When lymphocytic infiltration of the bone marrow is present or the bone marrow is hypoplastic, the daily dose should not exceed 0.1 mg/kg bodyweight.
Children with nephrotic syndrome, patients prescribed high pulse dosing regimens and patients with a history of seizure disorder, should be closely monitored following administration of LEUKERAN, as they may have an increased risk of seizures.
Mutagenicity and carcinogenicity: LEUKERAN has been shown to cause chromatid or chromosome damage in man.
Acute secondary haematologic malignancies (especially leukaemia and myelodysplastic syndrome) have been reported, particularly after long term treatment (see Adverse Reactions).
A comparison of patients with ovarian cancer who received alkylating agents with those who did not, showed that the use of alkylating agents, including LEUKERAN, significantly increased the incidence of acute leukaemia.
Acute myelogenous leukaemia has been reported in a small proportion of patients receiving LEUKERAN as long term adjuvant therapy for breast cancer.
The leukaemogenic risk must be balanced against the potential therapeutic benefit when considering the use of LEUKERAN.
Effects on Ability to Drive and Use Machines: No data.