How it is administered

Doxorubicin is given as an intravenous (IV) injection or infusion. It is supplied as a sterile solution or a powder that is mixed with a liquid before use. The medication is administered through a vein, either as a quick injection over 3 to 10 minutes or as a longer infusion, often through a central line. The dose and schedule depend on your specific treatment plan and may be given alone or in combination with other chemotherapy drugs.

How it works

Doxorubicin is a type of chemotherapy known as an anthracycline. It works by interfering with the DNA inside cancer cells. Doxorubicin inserts itself between the DNA strands (a process called intercalation), which blocks the ability of the cell to copy its DNA and make new cells. It also inhibits an enzyme called topoisomerase II, which is necessary for DNA replication and repair. This leads to breaks in the DNA and ultimately causes the cancer cell to die.

Because doxorubicin targets rapidly dividing cells, it is effective against many types of cancer, including acute lymphoblastic leukemia (ALL). However, it can also affect healthy cells that divide quickly, such as those in the bone marrow, digestive tract, and hair follicles, leading to side effects.

Who Should take it

Doxorubicin is used to treat a variety of cancers, including acute lymphoblastic leukemia (ALL), acute myeloblastic leukemia, Hodgkin lymphoma, non-Hodgkin lymphoma, and several solid tumors. In the context of ALL, it is often part of a combination chemotherapy regimen designed to kill leukemia cells and achieve remission.

Your doctor will determine if doxorubicin is appropriate for you based on your specific diagnosis, overall health, and previous treatments. It is commonly used in both children and adults with ALL, although dosing and monitoring may differ for pediatric patients.

Who should not take it

You should not receive doxorubicin if you have:

• Severe heart problems or recent heart attack
• Severe, ongoing low blood cell counts due to previous chemotherapy
• Severe liver problems (such as very high bilirubin levels)
• A history of severe allergic reaction to doxorubicin

If you have had radiation therapy to the chest or are taking other medicines that can affect the heart, your doctor will carefully consider the risks. Women who are pregnant or breastfeeding should not take doxorubicin, as it can harm the baby.

Commonly used with

Doxorubicin is often used in combination with other chemotherapy drugs to treat ALL and other blood cancers. Common combinations include:

• Vincristine
• Cyclophosphamide
• Prednisone or dexamethasone
• Methotrexate
• Cytarabine

These combinations are designed to attack cancer cells in different ways for better results.

Commonly tested with

In clinical studies and treatment protocols for ALL, doxorubicin is frequently tested with other chemotherapy agents, such as:

• Vincristine
• Cyclophosphamide
• Methotrexate
• Cytarabine
• Prednisone or dexamethasone

These combinations are standard in multi-agent chemotherapy regimens for leukemia and lymphoma, and are carefully adjusted based on patient age, disease risk, and response to treatment.