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carmustine (bis-chloroethylnitrosourea, bcnu, bicnu) is a medication used mainly for chemotherapy. it is a nitrogen mustard ß-chloro-nitrosourea compound used as an alkylating agent. description carmustine is an orange-yellow solid medication used mainly for chemotherapy. it is a nitrogen mustard ß-chloro-nitrosourea compound. mechanism of action as an alkylating agent, carmustine can form interstrand crosslinks in dna, which prevents dna replication and dna transcription.<citation>needed] uses carmustine is used as an alkylating agent to treat several types of brain cancer including glioma, glioblastoma multiforme, medulloblastoma and astrocytoma), multiple myeloma, and lymphoma (hodgkin's and non-hodgkin). bcnu is sometimes used in conjunction with alkyl guanine transferase (agt) inhibitors, such as o6-benzylguanine. the agt-inhibitors increase the efficacy of carmustine by inhibiting the direct reversal pathway of dna repair, which will prevent formation of the interstrand crosslink between the n1 of guanine and the n3 of cytosine. it is also used as part of a chemotherapeutic protocol in preparation for hematological stem cell transplantation, a type of bone marrow transplant, in order to reduce the white blood cell count in the recipient. use under this protocol, usually with fludarabine and melphalan, was developed by oncologists at the university of texas md anderson cancer center.<citation>needed]