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Thiotepa is a small molecule, polyfunctional alkylating agent and a derivative of nitrogen mustard. It acts by forming highly reactive ethylenimine radicals that cross-link DNA strands, thereby interfering with DNA, RNA, and protein synthesis. This action is not cell cycle phase-specific and results in the inhibition of cancer cell growth and division. Thiotepa also has immunosuppressive properties. It is primarily used to treat breast cancer, ovarian cancer, superficial papillary bladder carcinoma, malignant effusions (pleural, pericardial, peritoneal), and as conditioning therapy prior to hematopoietic progenitor (stem) cell transplantation in both adults and pediatric patients[1][2][3][4][5]. Its main toxicity is myelosuppression.
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