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Cytarabine is the core chemotherapy for acute myeloid leukaemia, given with an anthracycline as the classic 7+3 induction and at high doses for consolidation; it is also injected into the spinal fluid to treat or prevent leukaemia in the brain.
Cytarabine was approved in 1969 and remains, with an anthracycline, the remission-induction standard in acute non-lymphocytic leukaemia of adults and children; the label also covers acute lymphocytic leukaemia and blast-phase CML, and intrathecal use for prophylaxis and treatment of meningeal leukaemia. High-dose cytarabine consolidation (CALGB 8525) defined post-remission therapy for favourable-risk AML, and it partners fludarabine (FLAG), cladribine and midostaurin, gemtuzumab or venetoclax in modern regimens. A liposomal co-formulation with daunorubicin (CPX-351, Vyxeos) has its own record. Cerebellar toxicity at high doses, conjunctivitis (steroid eye drops) and profound myelosuppression are characteristic.
Converted to ara-CTP, which competitively inhibits DNA polymerase and is incorporated into DNA, halting chain elongation during S phase.
1.Cytarabine slips into a pocket on its target.
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Intrathecal treatment of lymphomatous meningitis
Accelerated approval on a surrogate endpoint, with a confirmatory trial required.
Intrathecal treatment of lymphomatous meningitis
Confirmed: the accelerated approval of 1999 converted to traditional approval 8.0 years after it was granted.
| Region | Year | Indication |
|---|---|---|
| US | 1969 | Remission induction in acute non-lymphocytic leukaemia; ALL; blast-phase CML; intrathecal therapy of meningeal leukaemia |
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CPX-351 is the preferred intensive induction for fit older patients with secondary or therapy-related AML in many centres, mainly as a bridge to allogeneic transplant.
One of the few maintenance strategies in lymphoma that improved overall survival rather than only progression-free survival, and the reason three years of rituximab became standard after autologous transplantation in mantle cell lymphoma.
MATRix became the reference induction for fit patients with primary CNS lymphoma and the control arm of later randomised trials.
Query for this drug: (TITLE:"Cytarabine" OR ABSTRACT:"Cytarabine" OR TITLE:"Cytosar-U" OR ABSTRACT:"Cytosar-U" OR TITLE:"historic" OR ABSTRACT:"historic" OR TITLE:"Ara-C" OR ABSTRACT:"Ara-C" OR TITLE:"Cytosine arabinoside" OR ABSTRACT:"Cytosine arabinoside" OR TITLE:"DepoCyt liposomal, discontinued" OR ABSTRACT:"DepoCyt liposomal, discontinued") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Cytarabine, not a curated reading list.
Shares A Safety and Efficacy Study of Eltrombopag in Subjects With AML, Clofarabine Plus Cytarabine Versus Conventional Induction Therapy And A Study Of NK Cell Transplantation In Newly Diagnosed Acute Myeloid Leukemia, CPX-351 versus 7+3 chemotherapy in older adults with newly diagnosed secondary acute myeloid leukaemia, Study of Magrolimab in Combination With Azacitidine Versus Physician's Choice of Venetoclax in Combination With Azacitidine or Intensive Chemotherapy in Patients With TP53 Mutant Acute Myeloid Leukemia That Have Not Been Treated and the tag generic.
Shares A Study of ASP2215 Versus Salvage Chemotherapy In Patients With Relapsed or Refractory Acute Myeloid Leukemia (AML) With FMS-like Tyrosine Kinase 3 (FLT3) Mutation, Combination Chemotherapy With or Without G-CSF in Treating Older Patients With Acute Myeloid Leukemia, Combination Chemotherapy With or Without Bone Marrow Transplantation in Treating Children With Acute Myeloid Leukemia, Treatment of Patients With Newly Diagnosed Acute Myeloid Leukemia or Myelodysplasia and the tag generic.
Shares LCH-IV, International Collaborative Treatment Protocol for Children and Adolescents With Langerhans Cell Histiocytosis, Inotuzumab Ozogamicin and Frontline Chemotherapy in Treating Young Adults With Newly Diagnosed B Acute Lymphoblastic Leukemia, International Collaborative Treatment Protocol For Children And Adolescents With Acute Lymphoblastic Leukemia, Combination Chemotherapy With or Without Lestaurtinib in Treating Younger Patients With Newly Diagnosed Acute Lymphoblastic Leukemia and the tag generic.
Shares Response-Based Chemotherapy in Treating Newly Diagnosed Acute Myeloid Leukemia or Myelodysplastic Syndrome in Younger Patients With Down Syndrome, Combination Chemotherapy, Biological Therapy, and Bone Marrow Transplantation in Treating Patients With Acute Myeloid Leukemia, Inotuzumab Ozogamicin and Frontline Chemotherapy in Treating Young Adults With Newly Diagnosed B Acute Lymphoblastic Leukemia, International Collaborative Treatment Protocol For Children And Adolescents With Acute Lymphoblastic Leukemia and the tag generic.
Shares Combination Chemotherapy With or Without G-CSF in Treating Older Patients With Acute Myeloid Leukemia, BMT CTN 0803, IELSG32, MATRix/IELSG43 and the tag generic.
Shares A Study of ASP2215 Versus Salvage Chemotherapy In Patients With Relapsed or Refractory Acute Myeloid Leukemia (AML) With FMS-like Tyrosine Kinase 3 (FLT3) Mutation, Safety and Efficacy of Quizartinib in Children and Young Adults With Acute Myeloid Leukemia (AML), a Cancer of the Blood, DNA polymerase alpha (POLA1), A Global Study of Midostaurin in Combination With Chemotherapy to Evaluate Safety, Efficacy and Pharmacokinetics in Newly Diagnosed Pediatric Patients With FLT3 Mutated AML and the tag generic.
Shares BMT CTN 0803, Stem cell transplant in lymphoma: what it is still for, Relapsed and refractory classical Hodgkin lymphoma, Peripheral T-cell lymphomas (including cutaneous T-cell lymphoma) and the tag generic.
Shares LCH-IV, International Collaborative Treatment Protocol for Children and Adolescents With Langerhans Cell Histiocytosis, Treatment of Patients With Newly Diagnosed Acute Myeloid Leukemia or Myelodysplasia, Cytotoxic chemotherapy and the tag generic.