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How it is administered
Daunorubicin, when used for blood cancers like acute myeloid leukemia (AML), is commonly administered as part of a combination therapy with cytarabine in a liposomal formulation for intravenous (IV) infusion. The medication is supplied as a sterile, preservative-free, lyophilized cake in a single-dose vial. Each vial contains a fixed ratio of daunorubicin and cytarabine, and the medication is reconstituted and diluted before being given as a 90-minute IV infusion through a central venous catheter or a peripherally inserted central catheter.
It is not administered by mouth, subcutaneous, or intramuscular routes. 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 interfering with the DNA inside cancer cells. Specifically, it forms complexes with DNA, inhibits the enzyme topoisomerase II, and disrupts DNA polymerase activity. These actions prevent the cancer cells from dividing and growing, leading to their death.
When used in a liposomal formulation with cytarabine, the combination is designed to deliver both drugs directly to the bone marrow, where leukemia cells are most prevalent. The liposomes are taken up by leukemia cells more than normal bone marrow cells, and once inside, they release daunorubicin and cytarabine, enhancing their cancer-killing effects. This targeted delivery helps maximize the effect on leukemia cells while 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 (muscle or bone pain)
- Fatigue
- Abdominal pain
- Dyspnea (shortness of breath)
- Headache
- Cough
- Decreased appetite
- Arrhythmia (irregular heartbeat)
- Pneumonia
- Bacteremia (bacterial infection in the blood)
- Chills
- Sleep disorders
- Vomiting
All patients will experience low blood counts (neutropenia, thrombocytopenia, 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.
It is specifically used for patients who have not previously received treatment for these forms of AML. The medication is chosen based on the type of leukemia and the patient's overall health, and it is typically given under the supervision of a hematologist or oncologist experienced in treating blood cancers.
Who should not take it
Daunorubicin should not be taken by patients with a history of serious hypersensitivity reactions to daunorubicin, cytarabine, or any component of the formulation. It is also contraindicated in patients with severe cardiac impairment or those whose lifetime cumulative anthracycline exposure has reached the maximum recommended limit, due to the risk of heart damage.
Patients with Wilson’s disease or other copper-related metabolic disorders should avoid this medication unless the benefits outweigh the risks, as the formulation contains copper. It should not be used during pregnancy unless absolutely necessary, as it can harm the unborn baby. Always inform your healthcare provider of any allergies or pre-existing medical conditions before starting treatment.
Commonly used with
Daunorubicin is most commonly used in combination with cytarabine for the treatment of certain types of acute myeloid leukemia. This combination is provided in a fixed ratio in a liposomal formulation to enhance effectiveness against leukemia cells.
It may also be used with other supportive medications, such as antiemetics to prevent 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 the treatment of AML. The combination is compared to the standard '7+3' regimen (cytarabine and daunorubicin given separately) in studies to determine effectiveness and safety.
It is also studied alongside other supportive care agents, such as antibiotics, antifungals, and growth factors, to manage side effects and complications during treatment for blood cancers.
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