Busulfan may cause: September 2007
**Core Concept**
Busulfan is an alkylating agent used in chemotherapy, particularly for the treatment of chronic myeloid leukemia. It works by inducing cross-linking of DNA strands, which inhibits DNA replication and ultimately leads to cell death.
**Why the Correct Answer is Right**
Busulfan is a known carcinogen, and its long-term use can lead to the development of secondary malignancies. The mechanism behind this is thought to be related to the induction of genetic mutations in somatic cells, which can result in the formation of cancerous tumors. This is particularly concerning in patients who have received high doses of busulfan, such as those undergoing bone marrow transplantation.
**Why Each Wrong Option is Incorrect**
**Option A:** While busulfan is an alkylating agent, it is not primarily associated with causing nephrotoxicity. Nephrotoxicity is more commonly seen with platinum-based chemotherapeutic agents like cisplatin.
**Option B:** Busulfan is not primarily associated with causing cardiotoxicity. Cardiotoxicity is more commonly seen with anthracycline antibiotics like doxorubicin.
**Option C:** While busulfan can cause myelosuppression, it is not primarily associated with causing alopecia. Alopecia is more commonly seen with chemotherapeutic agents like cyclophosphamide.
**Clinical Pearl / High-Yield Fact**
It's essential to note that busulfan is a known teratogen, and its use during pregnancy can lead to congenital abnormalities. Therefore, women of childbearing age should be advised to use effective contraception while receiving busulfan therapy.
**Correct Answer:** C. Myelosuppression