Drugs Five Years Later

Abstract

Cytarabine is an effective agent in the treatment of acute leukemia. Since its approval by The Food and Drug Administration in 1969, the clinical effectiveness of this drug has increased as knowledge of its pharmacologic and biologic properties has been translated into clinical trials. A complete remission rate of greater than 50% can be achieved when cytarabine is used in combination with other agents in the treatment of adult acute myeloblastic leukemia. Remissions occur only after the development of significant bone-marrow hypoplasia, and the care of patients through this period of pancytopenia requires elaborate supportive techniques and facilities. The role of cytarabine in the treatment of acute lymphoblastic leukemia and lymphoma is still under clinical investigation and appears promising. Because the clinical effectiveness of cytarabine in the treatment of nonmalignant diseases has not been proved, its use in these disorders must be considered investigational and weighed against the serious bone-marrow suppression and potential long-term hazards of this drug.

Hepatotoxicity of Chemotherapy

“…In patients in whom biopsies have been possible, drug-induced cholestasis has been demonstrated [36,37]. Although 24 of 27 leukemic patients given high-dose ara-C by continuous infusion over 72 hours developed abnormal liver function tests [38], the effects are reversible and not dose-limiting [38][39][40].…”

Pulmonary complications of cytosine-arabinoside therapy: radiographic findings

“…Cytosine-arabinoside, a pynmidine nucleoside analog that produces a rapid and potent inhibition of DNA-synthesis in mammalian cells, is important in the therapy for acute leukemia and, to a lesser extent, non-Hodgkin's lymphoma [5]. The success rate appears to be dose-dependent since Ara-C administered as the single agent in doses of 10-30 mg/m2 leads to remission in 1 0-1 5% of previously untreated cases, whereas doses of 1 00-200 mg/rn2 are effective in approximately 30% of these cases [6].…”

Failure of intravenous and intrathecal cytarabine to modify central nervous system IgG synthesis in multiple sclerosis

“…1 , 2 , and 3 , Table 1 ) received intravenous infusions of ara-C at a standard dosage of 67 mg per square meter of body surface area for 4 hours three times daily [5]. Treatment doses, volumes, and time schedules are shown in Table 1.…”

“…and does the CNS irnmune system reaction in MS depend on rapid turnover of immune cells in the CNS? Ara-C was chosen because: (1) it inhibits the synthesis phase of DNA [5].…”