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How it is administered
Mitoxantrone is given as an intravenous (IV) infusion. The medication comes as a concentrate that must be diluted before use. It is administered by a healthcare professional, usually over 5 to 15 minutes, directly into a vein. It should never be given by any other route (not subcutaneous, intramuscular, intra-arterial, or intrathecal).
The dose and frequency depend on the specific condition being treated, body surface area, and other individual factors. For blood cancers, it is often given in cycles, sometimes in combination with other chemotherapy drugs.
How it works
Mitoxantrone works by interfering with the DNA in cancer cells. It is a DNA-reactive agent that binds to DNA, causing crosslinks and strand breaks, which prevents the cancer cells from growing and dividing. It also inhibits an enzyme called topoisomerase II, which is essential for DNA repair and replication.
Mitoxantrone’s action is not limited to a specific phase of the cell cycle, meaning it can affect both actively dividing and resting cells. This broad activity helps it target cancer cells effectively. In addition to its effects on cancer cells, mitoxantrone also suppresses the immune system by inhibiting the proliferation of certain immune cells, which is why it is also used in some autoimmune diseases.
Common side effects
- Nausea and vomiting
- Hair thinning or loss (alopecia)
- Menstrual disorders (including missed periods)
- Urinary tract infections
- Stomatitis (mouth sores)
- Diarrhea or constipation
- Arrhythmias (irregular heartbeats)
- Infections (due to low white blood cell counts)
- Fatigue
- Decreased blood counts (anemia, leukopenia, thrombocytopenia)
- Blue-green discoloration of urine for 24 hours after administration
Other possible side effects include abnormal liver function tests, abnormal heart function, and, rarely, allergic reactions or extravasation (leakage at the injection site).
Who Should take it
Mitoxantrone is used in combination with other approved drugs for the initial therapy of certain types of acute nonlymphocytic leukemia (ANLL) in adults. This includes myelogenous, promyelocytic, monocytic, and erythroid acute leukemias. While it is not specifically indicated for Hodgkin lymphoma, it may be used in some blood cancer regimens as determined by your oncologist.
It is also used for other conditions such as advanced hormone-refractory prostate cancer and certain forms of multiple sclerosis. The decision to use mitoxantrone is based on the type of cancer, previous treatments, and overall health.
Who should not take it
Mitoxantrone should not be used in patients who have had a prior allergic reaction (hypersensitivity) to it.
It should generally be avoided in patients with severe liver impairment, as the drug is cleared more slowly and can build up to dangerous levels. Patients with pre-existing myelosuppression (low blood counts from previous treatments) should not receive mitoxantrone unless the potential benefit outweighs the risk. It should also not be given to pregnant women, as it may cause harm to the unborn baby. Breastfeeding should be stopped before starting treatment.
Commonly used with
Mitoxantrone is commonly used in combination with other chemotherapy drugs, such as cytarabine, especially in the treatment of acute nonlymphocytic leukemia. It may also be combined with corticosteroids like prednisone or hydrocortisone in certain cancer regimens.
The specific combination depends on the type of cancer and the treatment protocol being followed.
Commonly tested with
Mitoxantrone has been tested in clinical trials with other chemotherapy agents, most notably cytarabine and daunorubicin, for leukemia. In prostate cancer, it has been studied in combination with corticosteroids such as prednisone or hydrocortisone.
For blood cancers, especially leukemia, mitoxantrone is often part of multi-drug regimens that are tailored to the individual patient’s needs.
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