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 by a healthcare professional, usually over 5 to 15 minutes, directly into a vein. It should never be given by subcutaneous, intramuscular, intra-arterial, or intrathecal routes.

The dose and schedule depend on the condition being treated, but for blood cancers such as acute nonlymphocytic leukemia (ANLL), it is commonly given in combination with other chemotherapy drugs.

How it works

Mitoxantrone is a type of chemotherapy called an anthracenedione. It works by interacting with the DNA in cancer cells. Specifically, it intercalates into DNA, causing crosslinks and breaks in the DNA strands. This disrupts the ability of cancer cells to grow and divide.

Mitoxantrone also inhibits an enzyme called topoisomerase II, which is necessary for DNA repair and uncoiling. By blocking this enzyme, mitoxantrone prevents cancer cells from repairing themselves, leading to cell death. It is effective against both rapidly dividing and non-dividing cells, which means it does not target a specific phase of the cell cycle. This broad activity makes it useful in treating various blood cancers.

Who should take it

Mitoxantrone is used in adults for the initial treatment of acute nonlymphocytic leukemia (ANLL), which includes myelogenous, promyelocytic, monocytic, and erythroid acute leukemias. It is typically given in combination with other chemotherapy drugs, such as cytarabine.

It may also be used in other cancers and in multiple sclerosis (not related to blood cancers), but its main use in blood cancer is for patients who need strong chemotherapy to control the disease. Your doctor will determine if mitoxantrone is appropriate based on your specific diagnosis and health status.

Who should not take it

Mitoxantrone should not be used in patients who have had a previous allergic reaction to it. It is also not recommended for people with severe liver impairment, as the drug is cleared more slowly and can accumulate to dangerous levels.

Patients with existing severe bone marrow suppression from previous treatments should not receive mitoxantrone unless the potential benefit outweighs the risk. It should not be given by any route other than intravenous infusion. Pregnant women should not use mitoxantrone, as it can harm an unborn baby. Women of childbearing age should have a pregnancy test before each dose and use effective contraception.

Commonly used with

For blood cancers like acute nonlymphocytic leukemia, mitoxantrone is most commonly used in combination with cytarabine. It may also be used with corticosteroids in other settings, such as prostate cancer.

Your healthcare team will decide on the best combination of medications based on your diagnosis and treatment plan.

Commonly tested with

Mitoxantrone has been tested in combination with cytarabine for the treatment of acute nonlymphocytic leukemia. It has also been studied with corticosteroids (such as prednisone or hydrocortisone) in other cancers.

In clinical trials, mitoxantrone is often compared to or combined with other chemotherapy agents like daunorubicin to determine the best treatment protocols for blood cancers.