Clinical and morphological side-effects of busulfan (Myleran) treatment.

Development of side-effects after long-term treatment with busulfan is described in a 61-year-old woman with chronic myelogenous leukemia. She developed severe pulmonary fibrosis and bilateral cataracts. Cellular atypia in bronchial and uterine cervical epithelium was present after 4 years of busulfan treatment, and in addition cellular abnormalities in the convoluted and collecting tubules of the kidney as well as in the liver were demonstrated. An Addisonian-like syndrome appeared with hyperpigmentation of the skin, fatigue, loss of weight and diarrheas. Her respiratory symptoms as well as her general clinical condition did not improve after therapy was discontinued. The side-effects of busulfan treatment are discussed and the literature is reviewed.