Melphalan (Alkeran®) Erythrocyte Agglutinin and Hemolytic Anemia
Authors: M. ELAINE EYSTER
Journal: Annals of Internal Medicine (1967)

Case Studies1 March 1967Melphalan (Alkeran®) Erythrocyte Agglutinin and Hemolytic AnemiaM. ELAINE EYSTER, M.D.M. ELAINE EYSTER, M.D.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-66-3-573 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptL-phenylalanine mustard (melphalan) is one of the most effective drugs currently available for the treatment of multiple myeloma. Toxic effects are thrombocytopenia and neutropenia. Milder side effects include nausea, vomiting, and dermatitis. Drug hypersensitivity with hemolytic anemia has not been reported.The present report describes a 62-year-old white man with multiple myeloma who developed a hemolytic anemia while being treated with melphalan (Alkeran®). Since no inherent red cell enzyme defect was apparent, the possibility of an immunologic mechanism was investigated. It was demonstrated that the patient's serum caused in vitro agglutination of compatible normal type O Rhored cells in...References1. HABERROSENFIELD GRE: Ficin treated red cells for hemagglutination, in P.H. Andresen Festskrift. Munksgaard, Copenhagen, 1957, p. 45. Google Scholar2. EYSTERNACHMANCHRISTENSONENGLE MERLWNRL: Structural characteristics of red cell autoantibodies. J. Immun. 96: 107, 1966. CrossrefGoogle Scholar3. SHULMAN NR: Mechanism of blood cell damage by adsorption of antigen-antibody complexes, in Immunopathology, 3d International Symposium, edited by GRABAR, P., MIESCHER, P. A. Grune & Stratton, Inc., New York, 1963, p. 338. Google Scholar4. SHULMAN NR: A mechanism of cell destruction in individuals sensitized to foreign antigens and its implications in auto-immunity. Combined clinical staff conference at the National Institutes of Health. Ann. Intern. Med. 60: 506, 1964. LinkGoogle Scholar5. HARRIS JW: Studies on the mechanism of a drug-induced hemolytic anemia. J. 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Y.This study was supported by research grants C-1905 and CA07968, National Cancer Institute, and by training grant 2A-5337, National Institutes of Health, Bethesda, Md.At the time this study was completed, Dr. Eyster was a Faculty Research Associate supported by grant PR A-35 from the American Cancer Society, New York, N. Y.Requests for reprints should be addressed to Elaine Eyster, M.D., 525 E. 68th St., New York, N. Y. 10021. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byDrugs that have been shown to cause drug-induced immune hemolytic anemia or positive direct antiglobulin tests: some interesting findings since 2007An update on drug-induced immune hemolytic anemiaTOXICITY OF CHEMOTHERAPYHemolytic anemia and cancerDrug-induced red cell dyscrasiasImmune Hemolytic Anemia in the AgedChemotherapeutic agents and the erythronMacromolecular interactions of [14C-ring]melphalan in bloodDrug-induced immune hemolytic anemiaDrugs, Chemicals and Hemolysis 1 March 1967Volume 66, Issue 3Page: 573-577KeywordsCancer treatmentDrugsHemolytic anemiaHypersensitivityMultiple myelomaNauseaNeutropeniaPhenylalanineResearch grantsVomiting ePublished: 1 December 2008 Issue Published: 1 March 1967 PDF downloadLoading ...