The Different Types of Chemotherapy Drugs

Alkylating agents directly damage DNA to prevent the cancer cell from reproducing. As a class of drugs, these agents are not phase-specific (in other words, they work in all phases of the cell cycle). Alkylating agents are used to treat many different cancers, including acute and chronic leukemia, lymphoma, Hodgkin disease, multiple myeloma, sarcoma, as well as cancers of the lung, breast, and ovary. Because these drugs damage DNA, they can cause long-term damage to the bone marrow. In a few rare cases, this can eventually lead to acute leukemia. The risk of leukemia from alkylating agents is "dose-dependent," meaning that the risk is small with lower doses, but goes up as the total amount of drug used gets higher. The risk of leukemia after alkylating agents is highest 5-10 years after treatment.

There are many different alkylating agents, including:

• Nitrogen mustards: such as mechlorethamine (nitrogen mustard), chlorambucil, cyclophosphamide (Cytoxan '), ifosfamide, and melphalan
• Nitrosoureas: which include streptozocin, carmustine (BCNU), and lomustine
• Alkyl sulfonates: busulfan,
• Triazines: dacarbazine (DTIC), and temozolomide (Temodar ')
• Ethylenimines: thiotepa and altretamine (hexamethylmelamine)

The platinum drugs (cisplatin, carboplatin, and oxalaplatin) are sometimes grouped with alkylating agents because they kill cells in a similar way. These drugs are less likely than the alkylating agents to cause leukemia.

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