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To the Editor:—
The paper by Sokal and Lessmann in The Journal, April 16, page 1765, on the effects of cancer chemotherapeutic agents on the human fetus is a valuable contribution, but I believe that the statement in their summary that "other drugs (than aminopterin) have proved far less toxic for the fetus than would have been anticipated from theoretical considerations or animal experiments" is misleading and potentially dangerous. The animal data indicate that antimetabolites are likely to cause abortion and resorption of embryos if administered early in gestation and fetal malformation if administered later during the major period of organogenesis (i. e., 10th to 12th day in the rat). These periods correspond roughly to the first trimester of human pregnancy, particularly to the first eight weeks. The second third of the 22-day rat pregnancy is not comparable to the second trimester of human pregnancy.Only three patients given 6-mercaptopurine
Rothberg H. EFFECTS OF CYTOTOXIC AGENTS ON THE FETUS. JAMA. 1960;173(14):1616. doi:10.1001/jama.1960.03020320096027