Procarbazine
Vista determinista de la entidad fuente YAML. La autoridad clínica sigue con los ID de fuente citados y estado de firma del revisor.
| ID | DRUG-PROCARBAZINE |
|---|---|
| Tipo | Fármaco |
| Aliaces | IndicarbMatulanoNatulanoПрокарбазин |
| Situación | reviewed 2026-04-26 | pending_clinical_signoff |
| Enfermedades | DIS-GLIOMA-LOW-GRADE DIS-PCNSL |
| Fuentes | SRC-NCCN-BCELL-2025 |
Datos sobre drogas
| Clase | alkylating_agent — hydrazine derivative (oral non-classic alkylator) |
|---|---|
| Mecanismo | Methylhydrazine prodrug undergoing hepatic CYP-mediated oxidation (CYP1A and CYP2B) to azoprocarbazine and ultimately to a methyldiazonium cation that methylates DNA at O6 and N7 of guanine, generating mono- adducts and inhibiting DNA, RNA, and protein synthesis. Lipophilic and crosses the blood-brain barrier — basis of its central role in PCNSL (R-MPV) and Hodgkin (BEACOPP) regimens. Reversibly inhibits monoamine oxidase (weak MAOI activity → tyramine and sympathomimetic interaction syndrome). |
| Dosificación típica | PCNSL R-MPV (DeAngelis): 100 mg/m² PO daily × 7 days every 14 days, cycles 1-5 with rituximab + HD-MTX + vincristine; continued in consolidation arms. Hodgkin BEACOPP escalated: 100 mg/m² PO days 1-7 every 21 days × 6 cycles (with bleomycin + etoposide + adriamycin + cyclophosphamide + vincristine + prednisone). PCV (oligodendroglioma): 60 mg/m² PO days 8-21 every 6 weeks. |
| Ucrania registrada | Falso |
| NSZU reembolsado | Falso |
| Ucrania verificada por última vez | 2026-04-27 |
Advertencias
- Mielosupresión — retraso del nadir 4-6 semanas; acumulación
- Secondary malignancies — well-documented AML / MDS risk in long-term Hodgkin survivors (alkylator class)
- Crisis hipertensiva con tiramina/interacción simpaticomimética (mecanismo MAOI)
Notas
Patient counseling on MAOI diet (avoid aged cheese, cured/smoked meats, fermented soy, broad beans, tap beer, draft wine, marmite) is mandatory and must be documented at every cycle. Avoid all SSRIs (fluoxetine, sertraline) and decongestants for 2 weeks after last dose. R-MPV (PCNSL) and BEACOPP-escalated (Hodgkin advanced-stage IPI≥3) are the principal modern uses; both are restricted to specialist centers in UA. AML risk is the dominant late toxicity in Hodgkin survivors and a key reason ABVD remains preferred over BEACOPP in early-stage / lower-IPI disease.
Utilizado por
Esquema terapéutico
REG-R-MPV- R-MPV (Rituximab + HD-Methotrexate + Procarbazine + Vincristine), 5 ciclos q14dREG-R-MPV-SALVAGE-PCNSL- Reinducción basada en HD-MTX salvada para PCNSL recaídaREG-RT-PCV-LGG- Radioterapia + PCV (procarbazine/lomustina/vincristine) — Glioma de alto riesgo de baja calidad