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and reacting with a relatively large number of phosphamidases, it cleaves, essentially releasing a cytostatic substance, bis-(2-chloroethyl)amine.

This means that the alkylating action of this drug is specifically directed toward cancerous cells. Cyclophosphamide is one of the most frequently used chemotherapeutic agents.

Cyclophosphamide is used both intravenously and orally. It is used for chronic lymphatic leukemia, Hodgkin's disease, Burkitt's lymphoma, multiple myeloma, and cancer of the breast, neck, ovaries, and so on. Synonyms of this drug are endoxan, cyclostin, cytoxan, cyclophosphane, and others.

Ifosfamide: Ifosfamide, 3-(2-chloroethyl)-2-[(2-chloroethyl)amino]tetrahydro-2H-1,3,2-oxazaphosphorin-2-oxide (30.2.1.17), which is viewed as an isomeric compound of cyclophosphamide (30.2.1.15) and which is analogous in terms of action, is made by reacting N-(2-chloroethyl)-N-(3-hydroxypropyl)amine with phosphorous oxychloride, giving 3-(2-chloroethyl)-2-chlorotetrahydro-2H-1,3,2-oxazaphosphorin-2-oxide (30.2.1.16), which is reacted with N-(2-chloroethyl)amine, forming the desired ifosfamide (30.2.1.17) [60-62].

Ifosfamide is an experimental drug that is analogous to cyclophosphamide. Synonyms of this drug are goloxan and mitoxan.

30.2.2 Ethylenimine derivatives

Ethylenimines are highly reactive alkylating reagents. They alkylate DNA at position N7 of guanine, analogous to mechlorethamine. Ethyenimines exhibit cytostatic action and suppress development of proliferating, as well as malignant tissues. They disrupt the metabolism of nucleic acids and block mitotic cell division.

They are used for breast and ovarian cancer, nonoperable tumors, and other reoccurrences and metastases. In medicine, triethylenphosphortriamide, or thiotepa (30.2.2.1) is generally used; however, other drugs are also used, including benzotef (30.2.2.2), dipin (30.2.2.3), thiodipin (30.2.2.4), fosphemide (30.2.2.5), and others.

Thiotepa: Thiotepa, tris(1-aziridinyl)phosphine sulfate (30.2.2.1), is made by reacting ethylenimine with phosphorous sulfochloride [63,64].

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