Procarbazine


Procarbazine (Natulan®, Matulane® ) is an alkylating agent.

Administered orally and totally absorbed by the digestive tract, its plasma half-life is short - around a few minutes, and is related to an important metabolism through erythrocyte and liver enzymes. It penetrates relatively well through the blood-brain barrier.

Formula of procarbazine

Main indications

The indications are now restricted

Hodgkin's disease as one agent of the MOPP protocol,

non Hodgkin's lymphoma (indications less and less frequently used)

gliobastoma, (almost no indications nowadays).

Dosage

For adults the usual oral dosage is 100-150 mg/m2/day for 10 days followed by a maintenance dose of 50-100 mg/day

Main toxicities

Only specific toxicities (or major toxicities) are described here. Other common chemotherapy toxicities are described in the chapter on chemotherapy toxicity.

Chemo-induced leukaemia

This risk is relatively high for ovarian cancers or myeloma which respond to this chemotherapy. Chemo-induced leukaemia is very resistant to any new therapy. It generally occurs before 5 years.

Skin allergy

.It is a rash which requires the stopping of treatment.

Pulmonary fibrosis

Rare and late (generally after a MOPP protocol)

Diverse neurological complications

Various complications have been described: somnolence, mental confusion, psycho-motor excitation, depression, pain, ataxia, hallucinations, psychotic disorder, sleeping difficulties and peripheral neuropathies. It is often difficult to distinguish between drug toxicity and lymphoma neurological extension.

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