Melphalan is used as an oral alkylating agent for the palliative treatment of multiple myeloma; clinical evidence indicates that at least one third of the patients treated respond. Further studies are required to determine whether it has any advantage over other orally administered alkylating agents in the long-range palliative control of multiple myeloma. Bone marrow depression, which is reversible and may be detected by white blood cell and platelet counts, is the most serious adverse reaction noted; gastrointestinal disturbances have also been observed.
An Alkylating Agent for Multiple Myeloma: Melphalan (Alkeran). JAMA. 1965;191(7):547–549. doi:10.1001/jama.1965.03080070031008
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