Nephrotoxicity of Methyl-CCNU

Abstract

To the Editor: In the May 24 issue of the Journal, Harmon et al. presented convincing evidence of renal insufficiency in six children treated with methyl-CCNU (1-[2-chloroethyl]-3-[4-methyl cyclohexyl]-1-nitrosourea) at total doses exceeding 1500 mg per square meter of body-surface area. Two additional patients receiving 775 mg per square meter and 1052 per square meter were found to have decreasing renal size. This observation complemented earlier reports of chronic nephrotoxicity with other nitrosoureas, BCNU (1,3-bis[2-chloroethyl 1]-1-nitrosourea) and CCNU.^{1 2 3} Because of current widespread use of the nitrosoureas in advanced metastatic disease and as adjuvants to surgical procedures, concern must be raised . . .