How it is administered

Daunorubicin is administered as part of a combination liposomal formulation with cytarabine for intravenous (IV) infusion. It is not given as a pill or injection into the muscle or under the skin. The medication is supplied as a sterile, preservative-free, purple, lyophilized cake in a single-dose vial, and is reconstituted and diluted before being infused over 90 minutes through a central venous catheter or a peripherally inserted central catheter.

How it works

Daunorubicin is an anthracycline topoisomerase inhibitor. In the liposomal combination with cytarabine, it works by forming complexes with DNA, inhibiting the activity of topoisomerase II, and interfering with the replication and repair of DNA in cancer cells. This action leads to cell death, particularly in rapidly dividing leukemia cells.

The liposomal formulation allows the medication to enter and persist in the bone marrow, where it is taken up by leukemia cells more than normal bone marrow cells. Once inside the cells, the liposomes break down and release daunorubicin and cytarabine, which then exert their anti-cancer effects. This targeted delivery helps maximize the effect on cancer cells while reducing exposure to healthy cells.

Who Should take it

Daunorubicin, in combination with cytarabine as a liposomal injection, is indicated for adults and pediatric patients 1 year and older with newly-diagnosed therapy-related acute myeloid leukemia (t-AML) or AML with myelodysplasia-related changes (AML-MRC).

It is not specifically indicated for Chronic Neutrophilic Leukemia (CNL), but it is used in certain types of blood cancers, particularly specific subtypes of acute myeloid leukemia. Your healthcare provider will determine if this medication is appropriate for your specific diagnosis and condition.

Who should not take it

You should not take daunorubicin (in combination with cytarabine as a liposomal injection) if you have a history of serious hypersensitivity reactions to daunorubicin, cytarabine, or any component of the formulation.

It is also not recommended for patients with significant cardiac dysfunction or those whose lifetime cumulative anthracycline exposure has reached the maximum recommended limit, as it can increase the risk of heart failure. Patients with Wilson’s disease or other copper-related metabolic disorders should use this medication only if the benefits outweigh the risks, due to the copper content in the formulation.

Commonly used with

Daunorubicin is most commonly used in combination with cytarabine as a fixed-dose liposomal formulation for the treatment of certain types of acute myeloid leukemia. It may also be used alongside supportive medications such as antiemetics (to prevent nausea), antibiotics, antifungals, and blood transfusions as needed during treatment.

Commonly tested with

Daunorubicin (in the liposomal combination with cytarabine) has been tested against the traditional 7+3 regimen (standard cytarabine and daunorubicin) in clinical trials for acute myeloid leukemia. It is also studied in combination with other supportive therapies, and sometimes as part of regimens leading up to hematopoietic stem cell transplantation.