II. Indications: As part of Combination Regimens

  1. Acute Myelogenous Leukemia (AML, adults)
  2. Acute Lymphocytic Leukemia (ALL, adults and children)

III. Mechanism

  1. See Antibiotic Chemotherapy
  2. Daunorubicin is an anthracycline Aminoglycoside antineoplastic
    1. Daunorubicin is isolated from the bacterium Streptomyces peucetius (or Streptomyces coeruleorubidus)
  3. Daunorubicin interacts with DNA via topoisomerase
    1. Similar clinical effects as with Doxorubicin (hydroxylated form of Daunorubicin)
    2. Inhibits DNA Replication and repair
    3. Inhibits RNA and Protein synthesis

IV. Medications

  1. Injection Solution: 5 mg/ml in 4 and 10 ml vials
  2. Combination Agents
    1. Daunorubicin AND Cytarabine Liposomal (Vyxeos)

V. Dosing

  1. See other references for disease specific dosing protocols
  2. Adjust dosing in renal Impairment and hepatic Impairment

VI. Adverse Effects

  1. Cardiotoxicity (esp. Children)
  2. Infusion Reaction
  3. Myelosuppression
  4. Urine Discoloration (transient red coloration)

VII. Safety

  1. Avoid in Lactation
  2. Avoid in pregnancy (all trimesters)
    1. Use reliable Contraception
    2. Daunorubicin crosses the placenta
  3. Monitoring
    1. Complete Blood Count
    2. Cardiac Function
    3. Renal Function tests
    4. Liver Function Tests

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