Procarbazine

Детермінований перегляд YAML-сутності з джерельної бази. Клінічний авторитет лишається за вказаними source ID та статусом клінічного sign-off.

ID	`DRUG-PROCARBAZINE`
Тип	Препарат
Синоніми	IndicarbMatulaneNatulanПрокарбазин
Статус	переглянуто 2026-04-26 \| очікує клінічного підпису
Хвороби	`DIS-GLIOMA-LOW-GRADE` `DIS-PCNSL`
Джерела	`SRC-NCCN-BCELL-2025`

Дані про препарат

Клас	alkylating_agent — hydrazine derivative (oral non-classic alkylator)
Механізм дії	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).
Типове дозування	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.
Зареєстровано в Україні	False
Відшкодовується НСЗУ	False
Остання перевірка для України	2026-04-27

Застереження

Myelosuppression — delayed nadir 4-6 weeks; cumulative
Secondary malignancies — well-documented AML / MDS risk in long-term Hodgkin survivors (alkylator class)
Hypertensive crisis with tyramine / sympathomimetic interaction (MAOI mechanism)

Нотатки

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.

Де використовується

Regimens

REG-R-MPV - R-MPV (Rituximab + HD-Methotrexate + Procarbazine + Vincristine), 5 cycles q14d
REG-R-MPV-SALVAGE-PCNSL - Salvage HD-MTX-based re-induction for relapsed PCNSL
REG-RT-PCV-LGG - Radiotherapy + PCV (procarbazine/lomustine/vincristine) — high-risk low-grade glioma