In 1949, the U.S. Food and Drug Administration (FDA) approved nitrogen mustard to kill cancer cells.

The major use of mechlorethamine was in a regimen with vincristine, procarbazine and prednisone, commonly referred to as MOPP, used to treat Hodgkin disease and lymphoma. In recent years, mechlorethamine has been replaced by more stable alkylating agents such as cyclophosphamide (COPP).

Current listed indications include Hodgkin’s disease, lymphosarcoma, chronic leukemias, polycythemia vera, mycosis fungoides and lung cancer. Mechlorethamine was previously available in 10 mg vials generically and under the brand name Mustargen.

The recommended dose varied with the indication, patient age and weight. Mechlorethamine is currently available as a topic gel for treatment of cutaneous T-cell lymphomas and mycosis fungoides, but requires special handling.

Mechlorethamine shares common side effects with other alkylating agents, which include nausea, vomiting diarrhea, alopecia, pruritus, bone marrow suppression and rash.