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Chlorambucil Poisoning

Alexander A. Green, MD; J. Lawrence Naiman, MD
Am J Dis Child. 1968;116(2):190-191. doi:10.1001/archpedi.1968.02100020192013.
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CHLORAMBUCIL (p-[di-2-chlorethyl-amino]-phenylbutyric acid), an aromatic nitrogen mustard, is widely used in the treatment of malignant lymphomas and chronic lymphatic leukemia. Modest overdosage in the course of therapy of these diseases causes bone marrow depression and gastrointestinal upset. We have recently observed a child who ingested a toxic dose of chlorambucil, and in view of the paucity of reported observations on the hematologic and neurologic effects, we are reporting the following case.

Report of a Case  A 2-year-old girl (St CHC, 64-03-303) ingested approximately ten 2-mg sugar-coated tablets of chlorambucil (approximately 1.5 mg/ kg) which her father had been taking as treatment for Hodgkin's disease. About 1½ hours later, the child began to vomit and appeared quite agitated. Because of increasing hyperactivity and irritability, she was brought to the St. Christopher's Hospital for Children three hours after the ingestion.The patient presented as a pale, lethargic child with staring gaze,


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