Immunosuppressive and Cytotoxic Chemotherapy: Long-Term Complications

Cytotoxic drugs are being widely used as immunosuppressive and anti-inflammatory agents in patients with nonneoplastic conditions. In addition, patients with specific forms of malignancies have achieved substantial increases in survival as a result of improvements in cancer chemotherapy. Both of these patient populations are at risk for the development of long-term complications of treatment. Of particular concern is the problem of cumulative organ toxicity that is insidious in onset and not manifested clinically until damage has become severe and irreversible. In this review, specific examples of long-term toxicity are discussed to illustrate the complexity and importance of this increasingly common clinical problem.