ABSTRACT
This chapter reviews the common chemotherapeutic agents used in the treatment of childhood malignancies, with particular emphasis on drug-induced toxicity. While cancer is uncommon in childhood, it remains the second leading cause of death in children older than 1 year of age. Drug-induced toxicities in children may be severe and have been associated with increased morbidity and mortality in the past. Current disease-specific treatment protocols are designed to be less toxic while maintaining efficacy. The principal toxicities of mechlorethamine are nausea, vomiting, bone marrow depression, and gonadal damage. Mechlorethamine is a derivative of sulfur mustard and was one of the first successful antineoplastic agents. Busulfan was the first antineoplastic agent recognized to cause pulmonary failure. The anthracyclines, doxorubicin and daunomycin, belong to the antibiotic class of antineoplastic drugs and have wide clinical use. Doxorubicin is the single most useful clinical antineoplastic agent and is effective in many pediatric malignancies, including acute leukemias, lymphomas, osteosarcoma, Ewing's sarcoma, Wilms' tumor, and neuroblastoma.
