How it is administered

Cytarabine is administered as an injection. It can be given intravenously (into a vein), subcutaneously (under the skin), or intrathecally (into the spinal fluid, using preservative-free preparations only). The specific method and schedule depend on the treatment plan and the type of blood cancer being treated. Cytarabine is not effective if taken by mouth.

How it works

Cytarabine is a type of chemotherapy medication that works by interfering with the growth of cancer cells. It is most effective against cells that are actively dividing. Cytarabine is taken up by cells and converted into a form that blocks DNA polymerase, an enzyme needed for DNA synthesis. This means it primarily affects cells during the S-phase of the cell cycle, when DNA is being copied. By disrupting DNA synthesis, cytarabine prevents cancer cells from multiplying and leads to their death.

Cytarabine can also be incorporated into the DNA and RNA of cells, causing further damage and preventing the cells from functioning normally. Because it targets rapidly dividing cells, it is particularly effective against blood cancers like leukemia and lymphoma, where cancer cells are dividing quickly.

Who Should take it

Cytarabine is used in combination with other approved anti-cancer drugs for the induction of remission in acute non-lymphocytic leukemia (including acute myeloid leukemia) in adults and children. It is also used in the treatment of acute lymphocytic leukemia and the blast phase of chronic myelocytic leukemia. Additionally, cytarabine can be administered intrathecally for the prevention and treatment of meningeal leukemia (leukemia involving the central nervous system).

For Burkitt Lymphoma, cytarabine may be included as part of combination chemotherapy regimens, especially if there is central nervous system involvement or high risk of spread to the brain or spinal cord.

Who should not take it

Cytarabine should not be taken by anyone who is hypersensitive (allergic) to cytarabine or any of its components. It should be used with caution in patients with pre-existing bone marrow suppression, liver or kidney impairment, or active infections, as it can further suppress the immune system and worsen these conditions.

Cytarabine can cause harm to unborn babies, so it should not be used during pregnancy unless absolutely necessary. Women of childbearing potential should avoid becoming pregnant while on this medication. It is also not recommended for use in breastfeeding mothers, as it is unknown if it passes into breast milk and could harm a nursing infant.

Commonly used with

Cytarabine is most often used in combination with other chemotherapy drugs, such as daunorubicin, doxorubicin, vincristine, cyclophosphamide, methotrexate, and prednisone, depending on the specific type of blood cancer being treated. For Burkitt Lymphoma, it may be part of intensive combination regimens that include several of these agents.

In some protocols, cytarabine is also used with supportive medications to prevent or treat side effects, such as anti-nausea drugs or antibiotics.

Commonly tested with

Cytarabine has been tested in clinical trials with other chemotherapy agents, especially anthracyclines like daunorubicin and doxorubicin, as well as with methotrexate, vincristine, and cyclophosphamide. These combinations are standard in the treatment of various leukemias and lymphomas, including regimens for Burkitt Lymphoma.

It is also tested in combination with intrathecal methotrexate and hydrocortisone for central nervous system prophylaxis or treatment.