Common brand names

• Cytosar-U

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 over several hours or as a rapid injection.
• Subcutaneous injection: Under the skin.
• Intrathecal injection: Directly into the fluid around the spinal cord (using preservative-free preparations only).

The specific method and schedule depend on the treatment plan and the type of blood cancer being treated.

How it works

Cytarabine is a type of chemotherapy medicine known as an antimetabolite. It works by interfering with the DNA synthesis of rapidly dividing cells, such as cancer cells. Cytarabine is especially effective during the S-phase of the cell cycle, when cells are actively making new DNA.

Once inside the body, cytarabine is converted into its active form, which inhibits an enzyme called DNA polymerase. This enzyme is essential for DNA replication. By blocking this process, cytarabine prevents cancer cells from multiplying and can lead to their death. It also gets incorporated into DNA and RNA, causing further disruption of cell function. Because it targets rapidly dividing cells, cytarabine can also affect normal cells that grow quickly, such as those in the bone marrow, leading to some of its side effects.

Who should take it

Cytarabine is used in combination with other approved anticancer drugs for the treatment of:

• Acute non-lymphocytic leukemia (also called acute myeloid leukemia or AML) in adults and children, both for inducing remission and for ongoing treatment.
• Acute lymphocytic leukemia (ALL) and the blast phase of chronic myelocytic leukemia (CML).
• Meningeal leukemia: Cytarabine can also be given intrathecally (into the spinal fluid) for the prevention and treatment of leukemia involving the central nervous system.

Your doctor will determine if cytarabine is appropriate for you based on your specific diagnosis and overall health.

Who should not take it

Cytarabine should not be used in patients who are allergic or hypersensitive to the drug.

Caution is needed in patients with pre-existing bone marrow suppression, liver or kidney impairment, or those who are pregnant, as cytarabine can cause harm to an unborn baby. Women of childbearing potential should avoid becoming pregnant during treatment. It is also not recommended for use in breastfeeding mothers, as it is not known if the drug passes into breast milk and could harm a nursing infant.

If you have a history of severe reactions to cytarabine or any of its components, you should not receive this medication.

Commonly used with

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

• Daunorubicin (especially in the '7+3' regimen for AML)
• Other antineoplastic agents such as cyclophosphamide, vincristine, prednisone, and asparaginase, depending on the specific type of leukemia or lymphoma being treated.

The choice of combination depends on the type of blood cancer and the treatment protocol.

Commonly tested with

Cytarabine is frequently tested in clinical studies with other chemotherapy agents, particularly:

• Daunorubicin (as in the '7+3' regimen for AML)
• Anthracyclines and other drugs used in induction and consolidation therapy for leukemia
• Methotrexate and hydrocortisone (especially for central nervous system prophylaxis in leukemia)

It may also be studied with newer targeted therapies or as part of bone marrow transplant conditioning regimens.