How it is administered

Mitoxantrone is given as an intravenous (IV) infusion. It comes as a concentrated solution 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 is not given by mouth, subcutaneous, intramuscular, or intrathecal routes.

How it works

Mitoxantrone is a type of chemotherapy medicine known as an anthracenedione. It works by interfering with the DNA in cancer cells. Specifically, mitoxantrone intercalates into the DNA, causing crosslinks and strand breaks, which prevents the cancer cells from dividing and growing. It also inhibits an enzyme called topoisomerase II, which is necessary for repairing and uncoiling DNA. This action leads to the death of both rapidly dividing and non-dividing cells, making it effective against certain types of blood cancers.

Mitoxantrone also impacts the immune system by inhibiting the activity of certain immune cells, such as B cells, T cells, and macrophages. This can help reduce inflammation and abnormal immune responses, which is why it is also used in some autoimmune conditions.

Who Should take it

Mitoxantrone is approved for use in adults as part of combination chemotherapy for the initial treatment of acute nonlymphocytic leukemia (ANLL), which includes myelogenous, promyelocytic, monocytic, and erythroid acute leukemias. It is also used in combination with corticosteroids for advanced hormone-refractory prostate cancer, and for reducing disability and relapses in certain types of multiple sclerosis.

While mitoxantrone is not specifically indicated for chronic eosinophilic leukemia, it may be considered in certain cases of blood cancers where other treatments have not been effective, always under the guidance of a specialist familiar with chemotherapy.

Who should not take it

Mitoxantrone should not be used by anyone who has had a prior allergic reaction (hypersensitivity) to mitoxantrone. It should also be avoided in patients with pre-existing severe myelosuppression (very low blood cell counts) unless the potential benefits outweigh the risks.

Patients with severe liver dysfunction should not receive mitoxantrone, as the drug is cleared more slowly and can accumulate 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. Breastfeeding should be discontinued before starting mitoxantrone, as it passes into breast milk and may harm a nursing infant.

Commonly used with

For blood cancers, mitoxantrone is most commonly used in combination with cytarabine (a chemotherapy drug) for the treatment of acute nonlymphocytic leukemia. In prostate cancer, it is used with corticosteroids such as prednisone or hydrocortisone.

Your doctor may also prescribe supportive medications to help manage side effects, such as anti-nausea medicines or antibiotics if you develop an infection.

Commonly tested with

Mitoxantrone has been tested in combination with cytarabine for leukemia, and with corticosteroids (prednisone or hydrocortisone) for prostate cancer. It has also been studied with methylprednisolone for multiple sclerosis.

In clinical trials, mitoxantrone is often compared to other chemotherapy agents, such as daunorubicin, to evaluate its effectiveness and safety.