How it Works

Cytarabine belongs to a class of medications called antimetabolites. It works by inhibiting the synthesis of DNA, which is necessary for the proliferation and survival of cancer cells.Cancer cells cannot divide and replicate without the ability to produce new DNA. This leads to their death, which helps control cancer growth and spread. It also has antiviral and immunosuppressant properties.

Cancer cells, including those in acute myeloid leukemia (AML), have a much higher rate of cell division than normal cells. To divide and replicate, cancer cells must produce new DNA. Cytarabine interferes with this process by inhibiting an enzyme called ribonucleotide reductase, which is responsible for converting the building blocks of DNA into DNA strands.

Anti-metabolites masquerade as purine or pyrimidine - which become the building blocks of DNA. They prevent these substances from becoming incorporated into DNA during the "S" phase (of the cell cycle), stopping normal development and division. 

How it’s Administered

• Cytarabine can be given as an infusion into a vein (intravenous, IV).
• By injection into the layer of tissue between the skin and the muscle (subcutaneous or SubC).
• By injection into the muscle (intramuscular or IM).
• Another method is intraventricular or intrathecal infusion. 

Who Should Take Cytarabine

• Patients diagnosed with acute non-lymphocytic leukemia, acute lymphocytic leukemia and blast phase of chronic myelocytic leukemia.
• Is also indicated in combination with daunorubicin for the treatment of newly-diagnosed therapy-related acute myeloid leukemia (t-AML) or AML with myelodysplasia-related changes (AML-MRC) in adults and pediatric patients 1 year and older.

Who Shouldn’t Take Cytarabine 

• Pregnant women. It is important to inform your healthcare provider if you are pregnant, or planning to become pregnant before starting treatment, as it may cause harm to the fetus.
• Breastfeeding women should suspend breastfeeding if they start taking this medication. 
• People who are allergic to the medication or any of its components.

The Most Common Side Effects of Taking Cytarabine Include:

• Decreased blood cell counts: Your levels of platelets, white and red blood cells may temporarily drop. Which may cause, fatigue, weakness, shortness of breath, increased risk of infections, bleeding or bruising. 
• Nausea and vomiting 
• Diarrhea
• Mouth sores
• Hair loss
• Skin changes such as dryness, peeling, or redness
• Numbness or tingling in the hands or feet (Neuropathy)
• Heart problems such as an irregular heartbeat or an increased risk of heart attack or stroke
• Damage to the liver or kidneys
• Changes in vision, such as double vision or difficulty seeing in low light

Commonly Used in Acute Myeloid Leukemia With

• Daunorubicin: This combination, also known as "7+3," is a standard treatment for AML. It consists of 7 days of treatment with cytarabine followed by 3 days of treatment with daunorubicin.
• Idarubicin: This combination, also known as "IDA," is another standard treatment for AML. It consists of 3 days of treatment with idarubicin followed by 7 days of treatment with cytarabine.
• All-Trans Retinoic Acid (ATRA), to treat APL
• Arsenic trioxide, to treat APL
• Venetoclax
• Glasdegib
• Gilteritinib, to treat FLT3 mutated AML
• Midostaurin, to treat FLT3 mutated AML
• Sorafenib, to treat FLT3 mutated AML
• Enasidenib, to treat IDH2 mutated AML
• Idosidenib, to treat IDH1 mutated AML
• Etoposide
• Mitoxantrone
• Fludarabine
• Cladribine
• Decitabine
• Gemtuzumab ozogamicin, to treat CD33 positive AML

TAKE A LOOK AT THE AVAILABLE CLINICAL TRIALS FOR AML

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Date last updated 12/22/22