How it is administered

Cytarabine is administered by injection and is not effective if taken by mouth. It can be given in several ways:

• Intravenous (IV) infusion or injection: Directly into a vein, either as a slow infusion or a quick injection.
• Subcutaneous injection: Injected under the skin.
• Intrathecal injection: Injected into the fluid surrounding the spinal cord (for certain types of leukemia involving the central nervous system). Only preservative-free formulations should be used for this route.

The specific schedule and method depend on your treatment plan and the type of leukemia being treated.

How it works

Cytarabine is a chemotherapy medication that works by interfering with the DNA of cancer cells. It is especially effective against cells that are actively dividing, which is why it is used to treat fast-growing blood cancers like acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), and lymphoblastic lymphoma.

Cytarabine is a cytotoxic agent, meaning it kills cells. It is converted inside the body into a form that blocks DNA polymerase, an enzyme needed for cells to make new DNA. Without the ability to make new DNA, cancer cells cannot divide and grow, leading to their death. Cytarabine is most effective during the S-phase of the cell cycle, when DNA is being copied. Because it also affects normal rapidly dividing cells, it can cause side effects related to the bone marrow, digestive tract, and hair follicles.

Who Should take it

Cytarabine is used in combination with other approved anti-cancer drugs for remission induction in acute non-lymphocytic leukemia (such as AML) in adults and children. It is also used for treating acute lymphocytic leukemia (ALL) and the blast phase of chronic myelocytic leukemia (CML).

For patients with blood cancers that have spread to the central nervous system (meningeal leukemia), cytarabine can be given intrathecally (into the spinal fluid) to treat or prevent disease in the brain and spinal cord. Your doctor will determine if cytarabine is right for you based on your diagnosis, age, and overall health.

Who should not take it

Cytarabine should not be used in patients who have a known hypersensitivity (allergic reaction) to cytarabine or any of its components.

Cytarabine is a potent bone marrow suppressant, so it should be used with caution in patients who already have low blood counts or impaired bone marrow function. It should also be used cautiously in people with liver or kidney problems, as these conditions can increase the risk of side effects. Pregnant women should avoid cytarabine due to the risk of harm to the unborn baby. If you are breastfeeding, you should not use cytarabine, as it is not known if the drug passes into breast milk and may harm a nursing infant.

Commonly used with

Cytarabine is most often used in combination with other chemotherapy drugs to increase its effectiveness. Common combinations include:

• Daunorubicin or other anthracyclines
• Vincristine
• Prednisone or other corticosteroids
• Cyclophosphamide
• Methotrexate (especially for central nervous system involvement)

Your treatment regimen will be tailored to your specific type of blood cancer and your overall health.

Commonly tested with

Cytarabine is frequently tested in combination with other chemotherapy agents in clinical trials for leukemia and lymphoma. Some common combinations include:

• Daunorubicin (as in the '7+3' regimen for AML)
• Etoposide
• Asparaginase
• Methotrexate (for CNS prophylaxis)

These combinations are designed to attack cancer cells in different ways and improve treatment outcomes.