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Pregnancy & Breastfeeding Resources
Current Studies at Motherisk
The Safety of Diclectin in Breastfeeding
Neurodevelopment of Children Exposed in-Utero to Chemotherapy for Maternal Breast Cancer (Dr. I Nulman)
Diclegis Surveillance Program Study
Diclectin Surveillance Program Study
Study seeks women between 4 and 12 weeks in their pregnancy with morning sickness (NVP)
Pregnancy in Women with Multiple Sclerosis
Alcohol Use during Pregnancy
Lamisil in Pregnancy
Meridia in Pregnancy
Autoimmune Diseases in Pregnancy Project
Cancer in Pregnancy: Chlorambucil
Chlorambucil (Leukeran) is an alkylating antineoplastic agent.
|In vitro studies||Embryonic cells||Blocking of the initiation step of DNA replication 1|
|Animal studies *||rats and mice||Teratogenesis||Growth retardation, defects of the nervous system, cleft palate, limb defects, and impairment of renal growth 1-3|
|Male mice||Mutagenesis||Chlorambucil induces specific locus and dominant lethal mutations in germ cells of male mice 4|
|Human studies||No epidemiological studies of congenital anomalies among the infants ofwomen treated with chlorambucil during pregnancy were found.|
|Case reports||1st trim exposure||There are three case reports of human fetuses aborted after first trimester exposure to chlorambucil:|
|5 - 11 weeks||1. A male fetus with agenesis of left kidney and ureter 5|
|0 - 20 weeks (+ prednisone)||2. One fetus of a set of twins aborted, with unilateral kidney and ureter agenesis. The other fetus was apparently normal 6|
|3 - 4 weeks||3. A fetus aborted showing retinal defect 7
There are also case reports of first trimester exposure to chlorambucil without adverse effects 8-11
|2nd and 3rd trim||There are few case reports of late pregnancy exposure without adverse effects in the newborn 8|
- Ashby et al: Aspects of the teratology of cyclophosphamide (NSC-26271).Cancer Treat Report 60:477-82, 1976.
- Sadler & Kochlar: Teratogenic effects of chlorambucil on in vivo and in vitro organogenesis in mice. Teratology12: 71-8, 1975.
- Kavlock et al: Chlorambucil induced congenital renal hypoplasia:effects on basal renal function in the developing rat. Toxicology40:247-58, 1986.
- Generoso et al: Dominat lethal and heritable translocation tests with chlorambucil and melphalan in male mice. Mutat Res 345: 167-80,1995.
- Shotton & Monie: Possible teratogenic effect of chlorambucil on a human fetus. JAMA 186: 180-1, 1963.
- Steege & Caldwell: Renal agenesis after first trimester exposure to chlorambucil. South Med J 73: 1414 ? 5, 1980.
- Rugh & Skaredoff: Radiation and radiomimetic chlorambucil and the fetal retina. Arch Oftalmol 74:382-393, 1965.
- Nicholson: Cytotoxic drugs in pregnancy: review of reported cases. J Obstet Gynecol Commonw 75:307-12, 1968.
- Baynes et al: Pregnancy in a case of chronic lymphatic leukemia. Br J Obstet Gynecol 75:1165-1168, 1968.
- Jacobs et al: Management of the pregnant patient with Hodgkin?s disease. Ann Int Med 95:669-75, 1981.
- Ba-Thike: Non-Hodgkin's lymphoma in pregnancy. Asia-Oceania Journal of Obstetrics & Gynaecology 16:229-32, 1990