Mitoxantrone
Malignancies for which mitoxantrone is used include: advanced, hormoneA chemical produced by cells that alters the activity of other cells. The chemicals may be lipids, such as testosterone and estrogen or proteins like insulin. Hormones may act at locations far from their site of origin. Estrogen, for example, is produced primarily by cells in the ovaries but acts on cells in the breast and elsewhere.-refractory Prostate cancer and Acute nonlymphocytic leukemiaA cancer affecting the cells that develop into white or red blood cells. Both of these cell types originate from stem cells in bone marrow. Red blood cells function to carry oxygen to our tissues and the white cells (leukocytes) are part of our immune system. The cancerous cells often accumulate in the blood. (ANLL). Mitoxantrone is also used in treatment of breast cancer and Non-Hodgkin's lymphomaA cancer arising in the lymphatic system. The white blood cells affected are part of the body's immune system. The lymphatic system is a large network of vessels that carry fluid and cells of the immune system around the body. Lymph nodes are regional collection centers in the lymphatic system. See also, 'lymphatic system'.. Also worth noting is that Mitoxantrone is administered as an intravenous infusion.1
Mitoxantrone (Novantrone®) is structurally similar to doxorubicin, as it is an antitumor antibiotic. It exerts its effects on cancer cells primarily through two mechanisms: Mitoxantrone wedges between the bases of DNAAbbreviation for deoxyribonucleic acid. Composed of very long strings of nucleotides, which are abbreviated as A, C, G and T. DNA is the storage form of our genetic material. All of the instructions for the production of proteins are encoded in our DNA. (intercalation) and blocks DNA synthesis and transcriptionThe production of an RNA molecule from a DNA template. An RNA copy of a gene is produced by an enzyme, RNA polymerase. The RNA produced can either be used directly in the cell or can be used to direct the production of a protein through the process of translation. Many of the genes that are altered in cancer cells have potent effects on the process of transcription. See transcription factor., causing cross links and strand breaks. Mitoxantrone inhibits the activity of an enzymeA protein that speeds up the process of chemical reactions in the body without becoming altered in the process. Almost every biological process is driven by the activity of enzymes. Without enzyme catalysts, the complex reactions that build and break down cell parts would not happen at a rate compatible with life. Enzyme names usually describe the reaction that is being catalyzed and all of them end in -ase., topoisomeraseAn enzyme that cuts double stranded DNA to reduce tension created during local unwinding of the helix. Unwinding of DNA is required for transcription, translation and replication. Chemotherapy drugs such as topotecan and etoposide (VP-16) inhibit topoisomerases. type II. This leads to breaks in the genomic DNA.1
The diagram below shows the 3D molecular structure of Mitoxantrone.
Common side effects of Mitoxantrone include myelosuppressionThe decreased activity of the blood cell precursors located in the bone marrow. Both red and white blood cells in the bloodstream originate from these cells which are often short-lived and are replaced constantly by rapidly dividing precursor stem cells. Chemotherapy agents, radiation and many other cancer treatments are designed to attack rapidly dividing cells and inhibit the activity of these normal bone marrow cells. Several side effects of cancer treatment, such as anemia and a decreased ability to fight infections (immunosuppression) are due to the effects of these treatments on bone marrow cells., nausea and vomiting, mucositis, diarrhea, alopecia and cardiotoxicity.1
Patients should note that after an infusion the urine may have a temporary blue-green tinting. Mitoxantrone is a suppressor of bone marrow activity. It is important to monitor blood cell and platelet counts throughout the duration of treatment with blood tests before each infusion. Mitoxantrone may also have toxic effects the liver, which require liver function to be monitored routinely. Also, heart function must be monitored to avoid irreversible effects of toxicity. Evaluations of the function of these systems should be made before each infusion. Mitoxantrone should not be taken by women who are pregnant and patients should not become pregnant while using this drug, as it may have harmful affects on the developing fetus. It is unclear whether this drug may have effects on fertility after treatment has ended.1
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