The effect of hypoxia and low pH on the cytotoxicity of chlorambucil

Int J Radiat Oncol Biol Phys. 1992;22(4):737-41. doi: 10.1016/0360-3016(92)90514-i.


Studies with mouse tumors have shown that the effectiveness of certain chemotherapeutic agents can be enhanced if they are used in appropriate combination with an anti-hypertensive drug such as hydralazine. This results in reduced tumor blood flow with, among other things, a consequent decrease in oxygenation and increase in acidity in the tumor tissue. The purpose of the present work was to determine to what extent hypoxia and low pH are involved in the mechanism of this effect for chlorambucil. V79-WNRE cells were exposed to various drug concentrations under aerobic or hypoxic conditions, pH 6.4 or 7.4. Measurements of cell survival following 1 hr exposure at 37 degrees C showed that pH 6.4 produced a large potentiation of cell killing by chlorambucil (ER = 4 approx.); hypoxia, on the other hand, had little effect. The potentiation was shown to be greatest for pH values below 7.0. HPLC measurements of drug uptake were made since it was anticipated that chlorambucil, a weak acid, might tend to accumulate in cells under conditions of low extracellular pH. It was found that at an extracellular pH of 6.4 the ratio of the intracellular (Ci) and extracellular (Ce) drug concentrations was increased 4.5 and 3.6 fold for aerobic and hypoxic conditions, respectively. This probably explains most, if not all, of the cell killing potentiation observed at low pH.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Cell Hypoxia / physiology*
  • Cell Survival / drug effects
  • Chlorambucil / therapeutic use*
  • Cricetinae
  • Drug Synergism
  • Hydralazine / therapeutic use
  • Hydrogen-Ion Concentration*
  • Mice
  • Mice, Inbred C3H
  • Neoplasm Transplantation
  • Neoplasms, Experimental / blood supply
  • Neoplasms, Experimental / drug therapy*


  • Chlorambucil
  • Hydralazine