Common brand names

• Novantrone

How it is administered

Mitoxantrone is given as an intravenous (IV) infusion. It is supplied as a concentrate that must be diluted before use. The medication is administered slowly into a vein, usually over 5 to 15 minutes, and should not be given by any other route (not subcutaneous, intramuscular, intra-arterial, or intrathecal). The dose and schedule depend on the condition being treated and your body surface area.

How it works

Mitoxantrone is a type of chemotherapy medication known as an anthracenedione. It works by binding to DNA in cancer cells, causing crosslinks and breaks in the DNA strands. This prevents the cancer cells from dividing and growing. Mitoxantrone also inhibits an enzyme called topoisomerase II, which is important for DNA repair and replication. By interfering with these processes, mitoxantrone leads to the death of both rapidly dividing and non-dividing cancer cells.

In blood cancers, such as certain leukemias, mitoxantrone can help reduce the number of abnormal cells and allow healthy blood cells to recover. It is also known to suppress the immune system by inhibiting the proliferation of B cells, T cells, and macrophages, which can be helpful in some autoimmune conditions.

Who should take it

Mitoxantrone is used in combination with other chemotherapy drugs for the initial treatment of adults with acute nonlymphocytic leukemia (ANLL), which includes myelogenous, promyelocytic, monocytic, and erythroid acute leukemias. While it is not specifically FDA-approved for B-cell prolymphocytic leukemia, it may be considered in certain blood cancers as part of a combination regimen, depending on your doctor’s recommendation.

It is also used in other conditions such as advanced hormone-refractory prostate cancer (in combination with corticosteroids) and for some types of multiple sclerosis. Your doctor will determine if mitoxantrone is appropriate for your specific diagnosis and health situation.

Who should not take it

Mitoxantrone should not be used in patients who have had a previous allergic reaction or hypersensitivity to mitoxantrone. It should also be avoided in patients with pre-existing severe myelosuppression (very low blood cell counts) unless the potential benefit outweighs the risk of further bone marrow suppression.

Patients with severe liver impairment should not receive mitoxantrone, as the drug is cleared more slowly and can build up to dangerous levels. It is not recommended for use in pregnant women, as it may cause harm to the unborn baby. Women who are able to become pregnant should have a pregnancy test before each dose and use effective contraception during treatment.

Commonly used with

For blood cancers, mitoxantrone is most commonly used in combination with cytarabine, especially for the treatment of acute nonlymphocytic leukemia. In prostate cancer, it is combined with corticosteroids such as prednisone or hydrocortisone. Your doctor may also prescribe supportive medications to help prevent or manage side effects, such as anti-nausea drugs or antibiotics.

Commonly tested with

Mitoxantrone has been tested in clinical trials with other chemotherapy agents, most notably cytarabine for leukemia. It has also been studied in combination with corticosteroids for prostate cancer and with methylprednisolone for multiple sclerosis. In research settings, it may be combined with other drugs depending on the specific blood cancer being studied.