Melphalan (Alkeran)

General information

Class/mechanism: Nitrogen mustard, alkylator. Melphalan is a bischloroethylamine alkylating agent that crosslinks DNA by binding at the N7 position of guanine, with activity against resting and proliferating cells.
Route: IV, PO
Extravasation: irritant or neutral, depending on reference

For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias such as Micromedex, Lexicomp, UpToDate (courtesy of Lexicomp), or the prescribing information.

Diseases for which it is used

• Acute promyelocytic leukemia
• CNS lymphoma
• Diffuse large B-cell lymphoma
• Ewing sarcoma
• Follicular lymphoma
• HIV-associated lymphoma
• Hodgkin lymphoma
• Light-chain (AL) amyloidosis
• Mantle cell lymphoma
• Multiple myeloma
• Neuroblastoma
• Plasma cell leukemia

Diseases for which it was used

• Breast cancer
• Ovarian cancer

Patient drug information

• Melphalan (Alkeran) patient drug information (Chemocare)
• Melphalan (Alkeran) patient drug information (UpToDate)

History of changes in FDA indication

• 1/17/1964: Initial FDA approval
• Indicated for the palliative treatment of multiple myeloma and for the palliation of non-resectable epithelial carcinoma of the ovary.

Also known as

• Generic names: L-PAM, L-Sacrolysin, L-Sarcolysin, MPL, phenylalanine mustard
• Brand names: Alkeran, Alkerana, Evomela, Levofolan, Melfalan