Carmustin

Carmustine, also known as BCNU, is a cytostatically active drug (molecular formula C5H9Cl2N3O2) from the group of nitrosoureas, which is used in the treatment of certain severe, advanced tumour diseases. Carmustine, like the nitrogen-lost derivatives and the related nitrosourea lomustine, contains chloroethyl residues and additionally a highly reactive nitroso group.

The carmustine molecules decompose spontaneously and release the alkylating ethyl carbonium ion, which causes cross-linking of the DNA by alkylation of guanine and cytosine.

In addition, isocyanates are formed, which also inhibit DNA repair by combining with the DNA polymerase. Carmustin and lomustin have a phase-independent effect, i.e. they also act on resting cells.

Treatment of brain tumours (carmustine, like lomustine, is a liquid: glioblastoma, brainstem glioma, medulloblastoma, astrocytoma and ependymoma, brain metastases) as well as the second therapy for non-Hodgkin lymphomas and Hodgkin's disease.

Severe, reversible delayed onset myelosuppression with thrombocytopenia.

Carmustine is toxic to the lungs (interstitial pneumonia, pulmonary fibrosis)

Because of its strong side effects Carmustin is used only in a very limited way. However, carmustine is considered irreplaceable for the preparation of patients for stem cell transplantation.

1. Graefe KH et al. non-selective cytotoxic chemotherapeutics (cytostatics) In: Graefe KH et al (Eds) Pharmacology and Toxicology. Georg Thieme Publisher Stuttgart S 667