Granulopoietic Toxicity of Cytotoxic Agents: Pathogenesis, Pathophysiology, Methods of Modulation, and Clinical Aspects

Abstract

Ideal cancer therapeutic agents would combine high antitumor activity with little or no toxicity to normal cellular systems. Unfortunately, most cytotoxic agents that are clinically available at the present time are far from fulfilling this ideal. As outlined in the previous chapters, they exert a variable toxicity to the hematopoietic systems and, from a clinical point of view, the granulopoietic system is the most important one. Myelotoxicity is the predominant and therefore the limiting toxicity of a number of chemotherapeutic agents, such as cytosine arabinoside, vinblastine, the alkylating agents and the nitrosoureas; other chemotherapeutic agents (such as MTX, 6-MP, 6-TG, the anthracyclines) may exert limiting toxic effects other than their myelosuppressive action.