Cyclophosphamide, a recently-developed alkylating agent that may be administered orally, intramuscularly, and intravenously, was given to 135 patients with a wide variety of malignant diseases. Significant benefit was obtained in patients with lymphomas and leukemias as well as malignant melanoma, multiple myeloma, and carcinoma of the ovaries, pancreas, and nasopharynx. The major toxic effects encountered were nausea (44/128), vomiting (34/128), alopecia (40/128), leukopenia (30/124), and thrombocytopenia (8/92). Different routes of administration and different dosages were found effective in the chroni leukemias as opposed to the "solid tumors. The lesser incidence of thrombocytopenia and wide antitumor spectrum combine to distinguish this drug from heretofore available alkylating agents. Optimal patient palliation can be obtained only through careful clinical and hematologic control to avoid undue manifestations of toxicity.
Solomon J, Alexander MJ, Steinfeld JL. CyclophosphamideA Clinical Study. JAMA. 1963;183(3):165–170. doi:10.1001/jama.1963.03700030041009
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