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Dose-limiting toxicity includes myelosuppression and cardiotoxicity (See WARNINGS). Other reactions include:

Cutaneous: Reversible alopecia occurs in most patients. Rash, contact dermatitis and urticaria have occurred rarely.

Gastrointestinal:Acute nausea and vomiting occur but are usually mild. Antiemetic therapy may be of some help. Mucositis may occur 3 to 7 days after administration. Diarrhea and abdominal pain have occasionally been reported.

Local: If extravasation occurs during administration, severe local tissue necrosis, severe celluli-tis, thrombophlebitis, or painful induration can result.

Acute Reactions: Rarely, anaphylactoid reaction, fever, and chills can occur. Hyperuricemia may occur, especially in patients with leukemia, and serum uric acid levels should be monitored.