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Information about Mitoxantrone
Liver safety of Mitoxantrone
Mitoxantrone therapy is often accompanied by mild to moderate elevations in serum aminotransferase levels, but in typical doses it rarely causes clinically apparent, acute liver injury.
Mechanism of action of Mitoxantrone
Mitoxantrone (mye tox’ an trone) is an antineoplastic antibiotic that is a synthetic derivative of doxorubicin and is considered an anthracenedione. It is believed to act by intercalating into helical double-stranded DNA causing cross links and strand breaks, thus blocking both DNA and RNA synthesis. Mitoxantrone has potent antitumor effects in vitro and has been evaluated in leukemia, lymphoma and several solid tumors in humans. Mitoxantrone also has immunosuppressive activity, inhibiting B cell, T cell and macrophage proliferation and decreasing tumor necrosis factor alpha and interleukin-2 secretion. These actions led to its evaluation in patients with progressive forms of multiple sclerosis where it was shown to have activity in decreasing the rates of relapse and development of new lesions.
FDA approval information for Mitoxantrone
Mitoxantrone was approved for use in the United States in 1987 and current indications include acute non-lymphocytic leukemia and advanced prostate cancer. Mitoxantrone is also approved for use in relapsing and progressive multiple sclerosis.
Dosage and administration for Mitoxantrone
Mitoxantrone is available in several generic formulations as a solution for injection (usually 2 mg/mL). Mitoxantrone is administered intravenously in varying doses typically ranging from 12 to 14 mg/m2 at intervals of every 3 months (multiple sclerosis) or in monthly cycles (prostate cancer and leukemia).
Side effects of Mitoxantrone
Side effects of mitoxantrone include bone marrow suppression, nausea, vomiting, abdominal discomfort, diarrhea, alopecia, headache, dizziness and rash. Serious side effects include febrile neutropenia, cardiac toxicity [similar to that caused by doxorubicin] and secondary leukemia in patients with multiple sclerosis.