Blood: anemia, leukopenia, thrombocytopenia, cumulative myelosuppression (with repeated administration).
The cardiovascular system: decreased myocardial contractility, development or aggravation of the course of heart failure (in patients who had previously received doxorubicin), cardiotoxicity.
Respiratory system: pneumopathy (in the form of acute respiratory distress syndrome). Can develop at low cumulative doses (20 mg / m2), but the average cumulative dose for the development of pneumopathy is 78 mg / m2. Premedication with glucocorticoids can reduce the incidence of pulmonary toxicity.
Digestive system: stomatitis, vomiting with blood, nausea, vomiting, loss of appetite, diarrhea.
Urinary system: nephrotoxicity (irritation of the urinary tract, increased urea and creatinine in the blood plasma, asymptomatic ulceration of the bladder at the site of resection with intravesical injection, it must be differentiated with a relapse of cancer), eosinophilic cystitis, severe (often irreversible) contractures of the bladder, the formation of papillate calcifications in place resection and calcification of the bladder.
Nephrotoxicity is represented by hemolytic-uremic syndrome (microangiopathic hemolytic anemia with a decrease in hematocrit to 25% or less), irreversible renal insufficiency, thrombocytopenia (less than 100 × 109/ l), proteinuria, less often - pulmonary hypertension, pulmonary edema, neurologic disorders and hypertension, fainting. Mortality is more than 50%. Cases of renal failure without hemolysis (can occur both with mono- and with polychemotherapy) are described.Transfusion of blood components in a number of patients can exacerbate the clinical picture. The frequency of occurrence is maximal with a cumulative dose of mitomycin exceeding 60 mg. Usually develops within a few months after administration. It may be useful to use epoetin beta, leading to hematological improvement, lowering the frequency of blood transfusions and slowing the progression of chronic renal failure. Interchangeable plasma transfusion and captopril administration may be effective.
Nervous system: numbness or tingling of fingers or feet, headache, asthenia (myasthenia), nausea, vomiting, confusion.
Body of vision: blurred vision, flattening of the anterior chamber, cataract, choroidal effusion, hypotonic maculopathy and suprachoroidal hemorrhage, endophthalmitis (with topical application during surgery for glaucoma), irritation, photophobia (with topical application during or after surgery for pterygium). Delayed effects: delayed wound healing, scleral and corneal vascularization, scleral calcification and ulceration, scleral or corneal perforation, necrotic scleritis, iridocyclitis, cataracts, glaucoma, symphobaron.
Leather: thrombophlebitis, cellulitis (with extravasation), the formation of violet strips on the nails with repeated injections, dermatitis, alopecia.
Allergy: skin rashes, rash and itching on the hands and in the genital area, severe eczema of the palms and soles (delayed hypersensitivity reaction of type IV), leukocytoclastic vasculitis (hypersensitivity reaction of type III).
Reproductive system: studies of the effect of mitomycin on fertility have not been carried out, but gonadal suppression (amenorrhea or azoospermia) is a frequent side effect of antitumor therapy (especially in combination with alkylating agents). Effects depend on the dose and duration of treatment and can be irreversible. Men of reproductive age during treatment with mitomycin and within 3 months after the end of therapy need the use of contraceptives.
Carcinogenicity (mutagenicity): secondary malignant tumors are a potential delayed side effect of many antitumor drugs. It is unclear whether this is due to their mutagenic or immunosuppressive effect. The effect of the dose and duration of treatment is unknown, but it assumes an increased risk with prolonged use. Mitomycin is carcinogenic to rats and mice.
Others: unusual weakness or fatigue, sepsis, impaired liver function, hepatic vein occlusion, acrocyanosis, hyperthermia.