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    Chemistry

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    Also known as: 148-82-3, Alkeran, Melfalan, L-pam, Phenylalanine mustard, L-sarcolysine
    Molecular Formula
    C13H18Cl2N2O2
    Molecular Weight
    305.20  g/mol
    InChI Key
    SGDBTWWWUNNDEQ-LBPRGKRZSA-N
    FDA UNII
    Q41OR9510P
    Melphalan
    An alkylating nitrogen mustard that is used as an antineoplastic in the form of the levo isomer - MELPHALAN, the racemic mixture - MERPHALAN, and the dextro isomer - MEDPHALAN; toxic to bone marrow, but little vesicant action; potential carcinogen.
    Melphalan is an Alkylating Drug. The mechanism of action of melphalan is as an Alkylating Activity.
    1 2D Structure

    Melphalan

    2 Identification
    2.1 Computed Descriptors
    2.1.1 IUPAC Name
    (2S)-2-amino-3-[4-[bis(2-chloroethyl)amino]phenyl]propanoic acid
    2.1.2 InChI
    InChI=1S/C13H18Cl2N2O2/c14-5-7-17(8-6-15)11-3-1-10(2-4-11)9-12(16)13(18)19/h1-4,12H,5-9,16H2,(H,18,19)/t12-/m0/s1
    2.1.3 InChI Key
    SGDBTWWWUNNDEQ-LBPRGKRZSA-N
    2.1.4 Canonical SMILES
    C1=CC(=CC=C1CC(C(=O)O)N)N(CCCl)CCCl
    2.1.5 Isomeric SMILES
    C1=CC(=CC=C1C[C@@H](C(=O)O)N)N(CCCl)CCCl
    2.2 Other Identifiers
    2.2.1 UNII
    Q41OR9510P
    2.3 Synonyms
    2.3.1 MeSH Synonyms

    1. 4-(bis(2-chloroethyl)amino)phenylalanine

    2. Alkeran

    3. L-pam

    4. Medphalan

    5. Merphalan

    6. Mustard, Phenylalanine

    7. Phenylalanine Mustard

    8. Sarcolysine

    9. Sarkolysin

    2.3.2 Depositor-Supplied Synonyms

    1. 148-82-3

    2. Alkeran

    3. Melfalan

    4. L-pam

    5. Phenylalanine Mustard

    6. L-sarcolysine

    7. L-phenylalanine Mustard

    8. L-sarcolysin

    9. P-l-sarcolysin

    10. 4-[bis(2-chloroethyl)amino]-l-phenylalanine

    11. Melphalanum

    12. Melfalano

    13. Phenylalanine Nitrogen Mustard

    14. Levofalan

    15. P-di-(2-chloroethyl)amino-l-phenylalanine

    16. Sarcolysinum

    17. Cb 3025

    18. Nci-c04853

    19. Levopholan

    20. Levofolan

    21. P-bis(beta-chloroethyl)aminophenylalanine

    22. L-3-(p-(bis(2-chloroethyl)amino)phenyl)alanine

    23. 3-(p-(bis(2-chloroethyl)amino)phenyl)-l-alanine

    24. L-sarkolysin

    25. P-n-bis(2-chloroethyl)amino-l-phenylalanine

    26. 4-(bis(2-chloroethyl)amino)-l-phenylalanine

    27. (2s)-2-amino-3-[4-[bis(2-chloroethyl)amino]phenyl]propanoic Acid

    28. 3-p-(di(2-chloroethyl)amino)-phenyl-l-alanine

    29. Alanine Nitrogen Mustard

    30. Cb-3025

    31. Sk 15673

    32. Sk-15673

    33. Sarcolycin, L-

    34. Nsc-8806

    35. Evomela

    36. L-phenylalanine, 4-(bis(2-chloroethyl)amino)-

    37. Chebi:28876

    38. P-n,n-bis(2-chloroethyl)amino-l-phenylalanine

    39. Chembl852

    40. Alkeran (tn)

    41. Rcra Waste Number U150

    42. Q41or9510p

    43. Alanine, 3-(p-(bis(2-chloroethyl)amino)phenyl)-, L-

    44. Alanine, 3-[p-[bis(2-chloroethyl)amino]phenyl]-, L-

    45. Nsc-241286

    46. 8057-25-8

    47. Ncgc00090757-02

    48. (2s)-2-azaniumyl-3-[4-[bis(2-chloroethyl)amino]phenyl]propanoate

    49. Dsstox_cid_804

    50. L-phenylalanine, 4-[bis(2-chloroethyl)amino]-

    51. Dsstox_rid_75797

    52. Dsstox_gsid_20804

    53. Melfalano [inn-spanish]

    54. Melphalanum [inn-latin]

    55. Phenylalanine, 4-[bis(2-chloroethyl)amino]-

    56. (s)-2-amino-3-(4-(bis(2-chloroethyl)amino)phenyl)propanoic Acid

    57. (2s)-2-amino-3-(4-[bis(2-chloroethyl)amino]phenyl)propanoic Acid

    58. (s)-2-amino-3-{4-[bis-(2-chloro-ethyl)-amino]-phenyl}-propionic Acid

    59. Nsc8806

    60. Cas-148-82-3

    61. Smr000058720

    62. Ccris 374

    63. Hsdb 3234

    64. Einecs 205-726-3

    65. Rcra Waste No. U150

    66. Nsc 241286

    67. Brn 2816456

    68. L-3-(para-(bis(2-chloroethyl)amino)phenyl)alanine

    69. Phelinun

    70. Unii-q41or9510p

    71. (2s)-2-amino-3-{4-[bis(2-chloroethyl)amino]phenyl}propanoic Acid

    72. Nsc241286

    73. Melphalan, Powder

    74. Prestwick_1006

    75. Melphalan [usan:usp:inn:ban:jan]

    76. Spectrum_000397

    77. Melphalan [inn]

    78. Melphalan [jan]

    79. Melphalan [mi]

    80. 3025 C.b.

    81. Melphalan [hsdb]

    82. Melphalan [iarc]

    83. Melphalan [usan]

    84. Spectrum2_000074

    85. Spectrum3_000684

    86. Spectrum4_000882

    87. Spectrum5_001601

    88. Melphalan [vandf]

    89. Dl-melphalan Hydrochloride

    90. 3-(p-(bis(2-chloroethyl)amino)phenyl)alanine

    91. Epitope Id:141802

    92. Melphalan [mart.]

    93. 4-[bis-(2-chloroethyl)amino]-l-phenylalanine

    94. Melphalan [who-dd]

    95. Schembl5872

    96. Bspbio_002407

    97. Kbiogr_001284

    98. Kbioss_000877

    99. 4-14-00-01689 (beilstein Handbook Reference)

    100. Mls001333666

    101. Mls002153368

    102. Bidd:gt0044

    103. Divk1c_000653

    104. Spectrum1500382

    105. Spbio_000287

    106. Melphalan (jp17/usp/inn)

    107. Gtpl7620

    108. Zinc1673

    109. Melphalan [orange Book]

    110. Dtxsid6020804

    111. Melphalan [ep Monograph]

    112. Niosh/ay3360000

    113. Hms502a15

    114. Kbio1_000653

    115. Kbio2_000877

    116. Kbio2_003445

    117. Kbio2_006013

    118. Kbio3_001627

    119. L-phenylalanine Mustard (l-pam)

    120. Melphalan [usp Monograph]

    121. Ninds_000653

    122. Hms2090b09

    123. Hms2091b16

    124. Hms2235d21

    125. Pharmakon1600-01500382

    126. Tox21_111010

    127. Tox21_202522

    128. Bdbm50025837

    129. Ccg-39704

    130. Dl-442

    131. Mfcd00057717

    132. Nsc757098

    133. S8266

    134. Akos015895374

    135. Tox21_111010_1

    136. Cs-3120

    137. Db01042

    138. Nsc-757098

    139. Idi1_000653

    140. Smp2_000174

    141. Ncgc00090757-01

    142. Ncgc00090757-03

    143. Ncgc00090757-04

    144. Ncgc00090757-05

    145. Ncgc00090757-06

    146. Ncgc00260071-01

    147. As-13314

    148. Hy-17575

    149. Sbi-0052787.p003

    150. Ay33600000

    151. 4-[bis(2-chloroethyl)-amino]-l-phenylalanine

    152. 4-[bis(2-chloroethyl)-amino]-l-phenyl-alanine

    153. 4-[bis(2-chloroethyl)amino]-(l)-phenylalanine

    154. C07122

    155. D00369

    156. Ab00053282-07

    157. Ab00053282-08

    158. Ab00053282_09

    159. 148m823

    160. A808810

    161. Alanine, 3-(p-(bis(2-chloroethyl)amino)phenyl)-

    162. Sr-05000001667

    163. Q2298283

    164. Sr-05000001667-1

    165. W-108096

    166. Brd-k87827419-001-02-8

    167. 2-amino-3-[4-bis(2-chloroethyl)amino]phenylpropanoic Acid

    168. (2s)-2-azanyl-3-[4-[bis(2-chloroethyl)amino]phenyl]propanoic Acid

    169. 2-amino-3-{4-[bis-(2-chloro-ethyl)-amino]-phenyl}-propionic Acid

    170. 2-amino-3-{4-[bis-(2-chloro-ethyl)-amino]-phenyl}-propionic Acid(l-pam)

    171. 2-amino-3-{4-[bis-(2-chloro-ethyl)-amino]-phenyl}-propionic Acid (melphalan)

    172. 2-amino-3-{4-[bis-(2-chloro-ethyl)-amino]-phenyl}-propionic Acid(melphalan)

    2.4 Create Date
    2005-08-01
    3 Chemical and Physical Properties
    Molecular Weight 305.20 g/mol
    Molecular Formula C13H18Cl2N2O2
    XLogP3-0.5
    Hydrogen Bond Donor Count2
    Hydrogen Bond Acceptor Count4
    Rotatable Bond Count8
    Exact Mass304.0745332 g/mol
    Monoisotopic Mass304.0745332 g/mol
    Topological Polar Surface Area66.6 Ų
    Heavy Atom Count19
    Formal Charge0
    Complexity265
    Isotope Atom Count0
    Defined Atom Stereocenter Count1
    Undefined Atom Stereocenter Count0
    Defined Bond Stereocenter Count0
    Undefined Bond Stereocenter Count0
    Covalently Bonded Unit Count1
    4 Drug and Medication Information
    4.1 Drug Information
    1 of 2  
    Drug NameAlkeran
    PubMed HealthMelphalan (By mouth)
    Drug ClassesAntineoplastic Agent
    Drug LabelALKERAN (melphalan), also known as L-phenylalanine mustard, phenylalanine mustard, L-PAM, or L-sarcolysin, is a phenylalanine derivative of nitrogen mustard. Melphalan is a bifunctional alkylating agent which is active against selective human neoplas...
    Active IngredientMelphalan hydrochloride; Melphalan
    Dosage FormInjectable; Tablet
    RouteInjection; Oral
    Strength2mg; eq 50mg base/vial
    Market StatusPrescription
    CompanyGlaxosmithkline

    2 of 2  
    Drug NameAlkeran
    PubMed HealthMelphalan (By mouth)
    Drug ClassesAntineoplastic Agent
    Drug LabelALKERAN (melphalan), also known as L-phenylalanine mustard, phenylalanine mustard, L-PAM, or L-sarcolysin, is a phenylalanine derivative of nitrogen mustard. Melphalan is a bifunctional alkylating agent which is active against selective human neoplas...
    Active IngredientMelphalan hydrochloride; Melphalan
    Dosage FormInjectable; Tablet
    RouteInjection; Oral
    Strength2mg; eq 50mg base/vial
    Market StatusPrescription
    CompanyGlaxosmithkline

    4.2 Therapeutic Uses

    Antineoplastic Agents, Alkylating; Myeloablative Agonists

    National Library of Medicine's Medical Subject Headings. Melphalan. Online file (MeSH, 2016). Available from, as of December 5, 2016: https://www.nlm.nih.gov/mesh/2016/mesh_browser/MBrowser.html

    /CLINICAL TRIALS/ ClinicalTrials.gov is a registry and results database of publicly and privately supported clinical studies of human participants conducted around the world. The Web site is maintained by the National Library of Medicine (NLM) and the National Institutes of Health (NIH). Each ClinicalTrials.gov record presents summary information about a study protocol and includes the following: Disease or condition; Intervention (for example, the medical product, behavior, or procedure being studied); Title, description, and design of the study; Requirements for participation (eligibility criteria); Locations where the study is being conducted; Contact information for the study locations; and Links to relevant information on other health Web sites, such as NLM's MedlinePlus for patient health information and PubMed for citations and abstracts for scholarly articles in the field of medicine. Melphalan is included in the database.

    NIH/NLM; ClinicalTrials.Gov. Available from, as of February 1, 2017: https://clinicaltrials.gov/ct2/results?term=MELPHALAN&Search=Search

    Melphalan is used as a drug to treat cancer and other medical conditions, including ovarian cancer, malignant melanoma, multiple myeloma, breast cancer, advanced prostate cancer, testicular cancer, chronic myelogenous leukemia, osteogenic sarcoma, polycythemia vera, amyloidosis, and scleromyxedema (a rare skin disease). It is also used as an insect chemosterilant.

    NTP; Report on Carcinogens, Fourteenth Edition (November, 2016); Available from, as of December 5, 2016: https://ntp.niehs.nih.gov/go/roc

    Melphalan is used alone and as a component of various chemotherapeutic regimens in the treatment of myltiple myeloma.

    American Society of Health-System Pharmacists 2016; Drug Information 2016. Bethesda, MD. 2016, p. 1172

    For more Therapeutic Uses (Complete) data for Melphalan (17 total), please visit the HSDB record page.

    4.3 Drug Warning

    Although its safety during pregnancy has not been evaluated, melphalan is potentially teratogenic and should not be used during this period unless absolutely necessary.

    American Medical Association, Council on Drugs. AMA Drug Evaluations Annual 1994. Chicago, IL: American Medical Association, 1994., p. 2015

    Melphalan should be used cautiously in patients with severe renal insufficiency.

    American Medical Association, Council on Drugs. AMA Drug Evaluations Annual 1994. Chicago, IL: American Medical Association, 1994., p. 2015

    With prolonged use, sterility occurs with all alkylators; females appear more sensitive than males. /Alkalating agents, oral/

    Knoben, J.E. and P.O. Anderson (eds.) Handbook of Clinical Drug Data. 6th ed. Bethesda, MD: Drug Intelligence Publications, Inc. 1988., p. 400

    Arterial or venous thrombosis, or pulmonary embolism, sometimes fatal, has been reported in patients receiving melphalan by regional isolated perfusion.

    American Society of Health-System Pharmacists 2016; Drug Information 2016. Bethesda, MD. 2016, p. 1172

    For more Drug Warnings (Complete) data for Melphalan (11 total), please visit the HSDB record page.

    4.4 Drug Indication

    For the palliative treatment of multiple myeloma and for the palliation of non-resectable epithelial carcinoma of the ovary. Has also been used alone or as part of various chemotherapeutic regimens as an adjunct to surgery in the treatment of breast cancer, alone or in combination regimens for palliative treatment of locally recurrent or unresectable in-transit metastatic melanoma of the extremities, as well as for the treatment of amyloidosis with prednisone.

    FDA Label

    High-dose of Phelinun used alone or in combination with other cytotoxic medicinal products and/or total body irradiation is indicated in the treatment of:

    - multiple myeloma,

    - malignant lymphoma (Hodgkin, non-Hodgkin lymphoma),

    - acute lymphoblastic and myeloblastic leukemia,

    - childhood neuroblastoma,

    - ovarian cancer ,

    - mammary adenocarcinoma.

    Phelinun in combination with other cytotoxic medicinal products is indicated as reduced intensity conditioning (RIC) treatment prior to allogeneic haematopoietic stem cell transplantation (allo-HSCT) in malignant haematological diseases in adults.

    Phelinun in combination with other cytotoxic medicinal products is indicated as conditioning regimen prior to allogeneic haematopoietic stem cell transplantation in haematological diseases in the paediatric population as:

    - Myeloablative conditioning (MAC) treatment in case of malignant haematological diseases

    - RIC treatment in case of non-malignant haematological diseases.

    5 Pharmacology and Biochemistry
    5.1 Pharmacology

    Melphalan is an antineoplastic in the class of alkylating agents and is used to treat various forms of cancer. Alkylating agents are so named because of their ability to add alkyl groups to many electronegative groups under conditions present in cells. They stop tumor growth by cross-linking guanine bases in DNA double-helix strands - directly attacking DNA. This makes the strands unable to uncoil and separate. As this is necessary in DNA replication, the cells can no longer divide. In addition, these drugs add methyl or other alkyl groups onto molecules where they do not belong which in turn inhibits their correct utilization by base pairing and causes a miscoding of DNA. Alkylating agents are cell cycle-nonspecific. Alkylating agents work by three different mechanisms all of which achieve the same end result - disruption of DNA function and cell death.

    5.2 MeSH Pharmacological Classification

    Antineoplastic Agents, Alkylating

    A class of drugs that differs from other alkylating agents used clinically in that they are monofunctional and thus unable to cross-link cellular macromolecules. Among their common properties are a requirement for metabolic activation to intermediates with antitumor efficacy and the presence in their chemical structures of N-methyl groups, that after metabolism, can covalently modify cellular DNA. The precise mechanisms by which each of these drugs acts to kill tumor cells are not completely understood. (From AMA, Drug Evaluations Annual, 1994, p2026) (See all compounds classified as Antineoplastic Agents, Alkylating.)

    Myeloablative Agonists

    Agents that destroy bone marrow activity. They are used to prepare patients for BONE MARROW TRANSPLANTATION or STEM CELL TRANSPLANTATION. (See all compounds classified as Myeloablative Agonists.)

    5.3 FDA Pharmacological Classification
    5.3.1 Active Moiety
    MELPHALAN
    5.3.2 FDA UNII
    Q41OR9510P
    5.3.3 Pharmacological Classes
    Alkylating Drug [EPC]; Alkylating Activity [MoA]
    5.4 ATC Code

    L01AA03

    L01AA03

    S76 | LUXPHARMA | Pharmaceuticals Marketed in Luxembourg | Pharmaceuticals marketed in Luxembourg, as published by d'Gesondheetskeess (CNS, la caisse nationale de sante, www.cns.lu), mapped by name to structures using CompTox by R. Singh et al. (in prep.). List downloaded from https://cns.public.lu/en/legislations/textes-coordonnes/liste-med-comm.html. Dataset DOI:10.5281/zenodo.4587355

    L - Antineoplastic and immunomodulating agents

    L01 - Antineoplastic agents

    L01A - Alkylating agents

    L01AA - Nitrogen mustard analogues

    L01AA03 - Melphalan

    5.5 Absorption, Distribution and Excretion

    Absorption

    Incomplete, variable, 25-89% post oral dose

    Route of Elimination

    The 24-hour urinary excretion of parent drug in these patients was 10% 4.5%, suggesting that renal clearance is not a major route of elimination of parent drug.

    Volume of Distribution

    0.5 L/kg

    Absorption melphalan from the GI tract is incomplete and extremely variable.

    American Society of Health-System Pharmacists 2016; Drug Information 2016. Bethesda, MD. 2016, p. 1172

    After admin of (3)H-labeled melphalan to Walker carcinoma-bearing rats, radioactivity was found in liver, spleen, kidney, intestine and Walker carcinoma and to lesser extent in bone marrow, muscle, skin, testis and brain, but not in DNA fraction of any of these tissues. Approx 25% of admin radioactivity was excreted in urine during 1st 48 hr.

    IARC. Monographs on the Evaluation of the Carcinogenic Risk of Chemicals to Humans. Geneva: World Health Organization, International Agency for Research on Cancer, 1972-PRESENT. (Multivolume work). Available at: https://monographs.iarc.fr/ENG/Classification/index.php, p. V9 174 (1975)

    We have studied the disposition and elimination of melphalan after intravenous administration in 9 patients with cancer. High-pressure liquid chromatography and (14)C-melphalan were used to assay drug concentration in plasma and urine. Composite plasma t1/2alpha was 7.7 +/- 3.3 and t1/2beta was 108 +/- 20.8 min for 8 of the patients. The mean 24-hr urinary excretion of melphalan was 13.0 +/- 5.4% of the administered dose. In 2 patients, 80% to 100% of the measured (14)C counts in plasma and urine samples at each study interval, up to 24 hr after drug administration, could be accounted for by the sum of parent compound, monohydroxy and dihydroxy products, and methanol nonextractable radioactivity (i.e., protein-bound activity). These data and evidence of rapid disappearance from plasma at 37 degrees /C/ in vitro suggest that spontaneous degradation, and not enzymatic metabolism, is the major determinant of the t1/2 of melphalan in vivo.

    PMID:445964 Alberts DS et al; Clin Pharmacol Ther 26 (1): 73-80 (1979)

    After iv admin of (14)C-labeled melphalan in female, weanling Yorkshire white pigs, tissue samples indicated bone and fat may be acting as depots for the drug. After 8 days, avg of 70% eliminated in urine. An avg of 4.02% of applied dose was absorbed after 14 days. Significant levels of radioactivity were also detected in skin surrounding site of application.

    Skierkowski P et al; Report; Iss Oorder No PB-290436, 1978, 41

    For more Absorption, Distribution and Excretion (Complete) data for Melphalan (12 total), please visit the HSDB record page.

    5.6 Metabolism/Metabolites

    Melphalan is not actively metabolised, it spontaneously degrades to mono and dihydroxy products.

    ... Most of administered dose is chemically altered and metabolites persist in the body.

    American Medical Association, Council on Drugs. AMA Drug Evaluations Annual 1994. Chicago, IL: American Medical Association, 1994., p. 2015

    We have studied the disposition and elimination of melphalan after intravenous administration in 9 patients with cancer. High-pressure liquid chromatography and (14)C-melphalan were used to assay drug concentration in plasma and urine. Composite plasma t1/2alpha was 7.7 +/- 3.3 and t1/2beta was 108 +/- 20.8 min for 8 of the patients. The mean 24-hr urinary excretion of melphalan was 13.0 +/- 5.4% of the administered dose. In 2 patients, 80% to 100% of the measured (14)C counts in plasma and urine samples at each study interval, up to 24 hr after drug administration, could be accounted for by the sum of parent compound, monohydroxy and dihydroxy products, and methanol nonextractable radioactivity (i.e., protein-bound activity). These data and evidence of rapid disappearance from plasma at 37 degrees /C/ in vitro suggest that spontaneous degradation, and not enzymatic metabolism, is the major determinant of the t1/2 of melphalan in vivo.

    PMID:445964 Alberts DS et al; Clin Pharmacol Ther 26 (1): 73-80 (1979)

    Melphalan is apparently eliminated from plasma by spontaneous hydrolysis, froming the monohydroxy and dihydroxy derivatives of the drug; no other metabolites have been identified in humans.

    American Society of Health-System Pharmacists 2016; Drug Information 2016. Bethesda, MD. 2016, p. 1172

    5.7 Biological Half-Life

    1.5 (±0.83) hours

    We have studied the disposition and elimination of melphalan after intravenous administration in 9 patients with cancer. High-pressure liquid chromatography and (14)C-melphalan were used to assay drug concentration in plasma and urine. Composite plasma t1/2alpha was 7.7 +/- 3.3 and t1/2beta was 108 +/- 20.8 min for 8 of the patients. The mean 24-hr urinary excretion of melphalan was 13.0 +/- 5.4% of the administered dose. In 2 patients, 80% to 100% of the measured 14C counts in plasma and urine samples at each study interval, up to 24 hr after drug administration, could be accounted for by the sum of parent compound, monohydroxy and dihydroxy products, and methanol nonextractable radioactivity (i.e., protein-bound activity). These data and evidence of rapid disappearance from plasma at 37 degrees /C/ in vitro suggest that spontaneous degradation, and not enzymatic metabolism, is the major determinant of the t1/2 of melphalan in vivo.

    PMID:445964 Alberts DS et al; Clin Pharmacol Ther 26 (1): 73-80 (1979)

    Intravenous admin (14)C-labeled melphalan in female, weanling Yorkshire white pigs indicated very slow elimination phase (half-life= 214 hr).

    Skierkowski P et al; Report; Iss Oorder No PB-290436, 1978, 41

    After iv admin in humans, the drug was distributed in total body water and disappeared with half-lives of approx 67 min and 160 hr. Up to 65% of label was recovered in urine over period of 7 days.

    PMID:648565 Tattersall MH et al; Eur J Cancer 14 (5): 507-13 (1978)

    The disappearance of L-PAM (intact drug) from the serum was biphasic after iv administration, with half-lives of 14 and 66 minutes for the alpha and beta phases, respectively.

    PMID:597816 Furner RL et al; Cancer Treat Rep 61 (9): 1637-46 (1977)

    For more Biological Half-Life (Complete) data for Melphalan (6 total), please visit the HSDB record page.

    5.8 Mechanism of Action

    Melphalan attaches alkyl groups to the N-7 position of guanine and N-3 position of adenine, leading to the formation of monoadducts, and DNA fragmenting when repair enzymes attempt to correct the error. It can also cause DNA cross-linking from the N-7 position of one guanine to the N-7 position of another, preventing DNA strands from separating for synthesis or transcription. Finally, melphalan can induce a number of different mutations.

    Melphalan, as an alkylating agent, interferes with DNA replication and transcription of RNA, and ultimately results in the disruption of nucleic acid function. Melphalan also possesses some immunosuppressive activity.

    American Society of Health-System Pharmacists 2016; Drug Information 2016. Bethesda, MD. 2016, p. 1172

    Melphalan is a direct-acting alkylating agent that is carcinogenic via genotoxic mechanism.

    IARC. Monographs on the Evaluation of the Carcinogenic Risk of Chemicals to Humans. Geneva: World Health Organization, International Agency for Research on Cancer, 1972-PRESENT. (Multivolume work). Available at: https://monographs.iarc.fr/ENG/Classification/index.php, p. V 100A P113

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    23-Jan-2021
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