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Effects of Long-Term Administration of Busulfan:  Report of a Patient With Generalized Nuclear Abnormalities, Carcinoma of Vulva, and Pulmonary Fibrosis

Martin L. Feingold, MD; Leopold G. Koss, MD
Arch Intern Med. 1969;124(1):66-71. doi:10.1001/archinte.1969.00300170068013.
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Since Galton's report in 1953,1 busulfan (Myleran) has been extensively used in the treatment of patients with chronic myelogenous leukemia. During the succeeding 14 years, there have been reports of various side effects of the drug, other than the bone-marrow depression attendant to its use. Pigmentation of the skin and a syndrome similar to Addison's disease1-7 amenorrhea,2 testicular atrophy,8 gynecomastia,4 and pulmonary fibrosis 3,5,9,10 have been observed clinically. Cytologic and histologic changes in various organs, most notably the urinary and respiratory tracts and the uterine cervix, were also reported.311-14 In addition, there has been a report of fetal abnormalities associated with busulfan administered during pregnancy.15

The purpose of this communication is to report the clinical and pathological observations on a patient with chronic myelogenous leukemia of nine years' duration, treated almost continuously with busulfan for a period of more than seven years. This

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