II. Indications

  1. FDA Approved (combination protocols)
    1. Acute Myelogenous Leukemia
    2. Prostate Cancer (Hormone refractory, symptomatic)
    3. Multiple Sclerosis (for refractory progressive or relapsing disease)
  2. Off-Label
    1. Breast Cancer
    2. Lymphoma (Hodgkin Lymphoma, Non-Hodgkin Lympoma)
    3. Autologous Hematopoietic Stem Cell Transplant (conditioning)

III. Mechanism

  1. See Antibiotic Chemotherapy
  2. Mitoxantrone is a anthracenedione Antibiotic with antineoplastic activity
    1. Doxorubicin Analog
  3. Mitoxantrone inserts into and crosslinks DNA
    1. Inhibits DNA and RNA replication
  4. Mitoxantrone binds topoisomerase 2
    1. Results in DNA strand breaks and inhibits DNA repair
    2. Inhibits proliferation of B Cells, T Cells and Macrophages
    3. Inhibits Antigen Presentation
    4. Decreases Cytokine release

IV. Medications

  1. Mitoxantrone Injection Solution: 20, 25 and 30 mg vials

V. Dosing

  1. See other references for disease specific dosing protocols

VI. Adverse Effects

  1. Severe skin and soft tissue necrosis on extravasation
    1. Mitoxantrone is a strong Vesicant (causes Blistering)
  2. Carcinogenic
    1. Risk of secondary malignancy (esp. )
  3. Cardiotoxicity
    1. Cardiomyopathy or Congestive Heart Failure
    2. Less cardiotoxic than Doxorubicin
  4. Myelosuppression
  5. Hyperuricemia
  6. Hepatotoxicity (increased Liver Function Tests)
  7. Urine Discoloration (transient blue-green coloration)
    1. May also transiently discolor the Sclera

VII. Safety

  1. Avoid in Lactation
  2. Avoid in pregnancy (all trimesters)
    1. Use reliable Contraception
  3. Monitoring
    1. Complete Blood Count
    2. Liver Function Tests
    3. Serum Uric Acid
    4. Echocardiogram with ejection fraction (baseline and prior to each dose)

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Related Studies

Ontology: Mitoxantrone (C0026259)

Definition (NCI_NCI-GLOSS) A drug used to treat advanced prostate cancer that does not respond to hormones, adult acute nonlymphocytic leukemia, and advanced or chronic multiple sclerosis. It is also being studied in the treatment of other cancers. It belongs to the family of drugs called antitumor antibiotics.
Definition (NCI) An anthracenedione antibiotic with antineoplastic activity. Mitoxantrone intercalates into and crosslinks DNA, thereby disrupting DNA and RNA replication. This agent also binds to topoisomerase II, resulting in DNA strand breaks and inhibition of DNA repair. Mitoxantrone is less cardiotoxic compared to doxorubicin.
Definition (MSH) An anthracenedione-derived antineoplastic agent.
Definition (CSP) 1,4-dihydroxy-5,8-bis((2-((2-hydroxyethyl) -amino) ethyl)amino) anthraquinone; cytotoxic compound with potentially therapeutic antitumor activity in breast cancer, lymphoma, and leukemia.
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D008942
SnomedCT 108791001, 386913001
English DHAQ, Mitozantrone, 9,10-Anthracenedione, 1,4-dihydroxy-5,8-bis((2-((2-hydroxyethyl)amino)ethyl)amino)-, 1,4-Dihydroxy-5,8-bis[[2-[(2-hydroxyethyl)amino]ethyl]amino]-9, 10-anthroquinone, 1,3-Dihydroxy-5,8-bis[[2-[(2-hydroxyethyl)amino]ethyl]amino]-9, 10-anthracenedione, Dihydroxyanthracenedione, mitoXANTRONE, Mitoxantrone [Chemical/Ingredient], mitozantrone, mitoXANtrone, Mitoxantrone, MITOXANTRONE, mitoxantrone, DHAD, Mitoxantrone product, Mitozantrone product, Mitoxantrone (product), Mitoxantrone (substance), dihydroxyanthracenedione
Swedish Mitoxantron
Czech mitoxantron
Finnish Mitoksantroni
Russian MITOZANTRON, MITOKSANTRON, МИТОЗАНТРОН, МИТОКСАНТРОН
Japanese ミトザントロン, ノバントロン, 塩酸ミトキサントロン, ミトキサントロン塩酸塩, ミトキサントロン
Italian Mitozantrone, Mitoxantrone
Polish Mitoksantron
Spanish mitoxantrona (producto), mitoxantrona (sustancia), mitoxantrona, Mitoxantrona, Mitozantrona
French Mitoxantrone
German Mitoxantron, Mitozantron
Portuguese Mitoxantrona, Mitozantrona