Myelosuppression is the dose-limiting side effect of all antibiotic chemotherapeutic agents except bleomycin where the dose-limiting side effects are neurological and dermatological.
The nadir of platelet and granulocyte count is generally 10-15 days after treatment (note though that it is 28 days following treatment with mitomycin). Mucositis is also maximal at this time.
Other toxic effects include:- - potentiation of local effects of irradiation. Also a radiation 'recall' phenomenon may be seen. - cardiac toxicity eg anthacycline antibiotics
Note that derangement in kidney or liver function can enhance the toxic effects of these drugs in normal tissues.
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