However, you should always inform your health care provider if you experience any unusual symptoms. Intramuscular administration of ALKERAN at and 60 mg kaufen gunstigsten alkeran m2 produced structural aberrations of the chromatid and chromosomes in bone marrow cells of Wistar rats. Cancer Chemotherapy Guidelines and Recommendations for Practice. Carcinogenesis Secondary malignancies, including acute nonlymphocytic leukemia, myeloproliferative syndrome, and carcinoma, have been reported in patients with cancer treated with alkylating agents including melphalan. As discussed below, overall response rates at week 22 were however, because of changes in trial design, conclusions as to the relative activity of the formulations after week 22 are impossible to make. Dose adjustment on the basis of blood counts at the nadir and day of treatment should be considered.