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How it is administered
Daunorubicin, when used in combination with cytarabine as a liposomal formulation, is administered by intravenous (IV) infusion. The medication comes as a sterile, preservative-free, purple, lyophilized cake in a single-dose vial. Each vial contains 44 mg daunorubicin and 100 mg cytarabine, encapsulated in liposomes.
The infusion is given over 90 minutes through a central venous catheter or a peripherally inserted central catheter. The dosing schedule depends on the treatment phase (induction or consolidation) and is based on body surface area (mg/m²).
How it works
Daunorubicin is an anthracycline topoisomerase inhibitor. It works by forming complexes with DNA, which inhibits the activity of topoisomerase II—an enzyme necessary for DNA replication and repair. This leads to the inhibition of DNA polymerase activity, affects gene expression, and produces DNA-damaging free radicals, all of which contribute to the death of rapidly dividing cancer cells.
When combined with cytarabine in a fixed 1:5 molar ratio and encapsulated in liposomes, daunorubicin and cytarabine show synergistic effects in killing leukemia cells. The liposomes help deliver the drugs directly to the bone marrow, where they are taken up by leukemia cells. Once inside the cells, the drugs are released, maximizing their effect on the cancer cells while potentially reducing exposure to healthy tissues.
Common side effects
- Hemorrhagic events (bleeding)
- Febrile neutropenia (fever with low white blood cell count)
- Rash
- Edema (swelling)
- Nausea
- Mucositis (mouth sores)
- Diarrhea
- Constipation
- Musculoskeletal pain
- Fatigue
- Abdominal pain
- Dyspnea (shortness of breath)
- Headache
- Cough
- Decreased appetite
- Arrhythmia (irregular heartbeat)
- Pneumonia
- Bacteremia (blood infection)
- Chills
- Sleep disorders
- Vomiting
All patients develop severe neutropenia, thrombocytopenia, and anemia during treatment.
Who Should take it
Daunorubicin, in combination with cytarabine as a liposomal formulation, is indicated 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.
This combination is used for patients who have specific types of blood cancers, particularly those that have developed after prior cancer treatments or are associated with certain changes in the bone marrow. It is not specifically indicated for chronic eosinophilic leukemia, but may be used in related blood cancers as determined by your healthcare provider.
Who should not take it
You should not take daunorubicin (in combination with cytarabine as a liposomal formulation) if you have a history of serious hypersensitivity (allergic) reactions to daunorubicin, cytarabine, or any component of the formulation.
It is also not recommended for patients with impaired cardiac function, or those who have reached the maximum cumulative lifetime dose of anthracyclines due to the risk of heart damage. Patients with Wilson’s disease or other copper-related metabolic disorders should use this medication only if the benefits outweigh the risks, as the formulation contains copper.
Commonly used with
Daunorubicin is commonly used in combination with cytarabine, especially in the treatment of certain types of acute myeloid leukemia. The two drugs are often administered together in a fixed ratio to maximize their effectiveness against leukemia cells.
It may also be used alongside supportive medications such as anti-emetics to manage nausea, antibiotics to prevent or treat infections, and transfusions to manage low blood counts.
Commonly tested with
Daunorubicin has been tested in combination with cytarabine in clinical trials for blood cancers such as acute myeloid leukemia. This combination is the basis of the liposomal formulation used in treatment.
It has also been compared to standard regimens of daunorubicin and cytarabine given separately, as well as with other supportive care measures in clinical studies.
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