Description of the medicine: Mitoxantrone (Mitoxantrone)
MITOXANTRON (Mitoxantrone). (The name of the drug is AWD, Germany). 1, 4-dihydroxy-5, 8-bis [[2 - [(2-hydroxyethyl) amino) ethyl] amino] anthraquinone.
Synonyms: Mitozantrone, Novatron.
Available in the form of hydrochloride. It is a synthetic antitumor agent. The chemical structure (the presence of an anthraquinone nucleus) has elements of similarity with antitumor anthracycline antibiotics (see Doxorubicin, Rubomycin).
Mitoxantrone is used for breast cancer with metastases, lymphomas (but not for lymphogranulomatosis), acute leukemia in adults (including blast crisis) and with exacerbation of chronic myelogenous leukemia, with hepatic cell carcinoma.
A solution of mitoxantrone is administered strictly intravenously slowly (not faster than within 5 minutes) or in the form of a short-term drip infusion (within 15 - 30 minutes). Dissolve the drug (according to the content in the vial) in 50 or 100 ml of an isotonic sodium chloride or glucose solution.
For breast cancer, non-Hodgkin’s lymphoma and hepatic cell carcinoma, 14 mg per 1 m2 of body surface is administered. Repeated injections are usually made after 21 days. With the general serious condition of the patient and suppression of blood formation, they are initially administered at a rate of 12 mg / m 2, and repeated injections are performed at intervals of 3-4 weeks.
With repeated injections, doses are selected taking into account the condition of the hematopoietic system. The number of leukocytes in the blood after administration of the drug should be at least 1, 5 x 10 9 / l, and platelets 50 x 10 9 / l.
Usually, after the administration of mitoxantrone, the number of leukocytes and platelets is restored after 21 days or earlier. In these cases, the initial dose is repeated after 21 days. If after 21 days the effect is not observed, wait until the blood picture is restored.
If the number of white blood cells after administration of the drug decreases to 1, 5 x 10 9 / l or more, and platelets 50 x 10 9 / l or more, then regardless of the period of recovery of the blood picture, the next dose is reduced by 2 mg / m2, with the number leukocytes less than 1 x 10 9 / l and platelets less than 25 x 10 9 / l the subsequent dose is reduced by 4 mg / m 2. In both cases, subsequent injections are made after restoration of the blood picture.
In acute leukemia, mitoxantrone is administered at 10-12 mg / m 2 per day for 5 days. The course of treatment can be repeated after the termination of the phenomena of inhibition of bone marrow hematopoiesis.
In cases of use in combination with other antitumor drugs, mitoxantrone is prescribed in doses 2-4 mg / m 2 lower than with monotherapy.
With all methods of application, the total dose per treatment course should not exceed 200 mg / m 2.
When using mitoxantrone, side effects are possible. Like other similar chemotherapeutic drugs, it causes inhibition of hematopoiesis (leukopenia, thrombocytopenia, less commonly erythrocytopenia). Like doxorubicin and other anthracycline antibiotics, mitoxantrone has a cardiotoxic effect.