Leukemia Cutis Medication

Updated: Feb 12, 2019
  • Author: Thomas N Helm, MD; Chief Editor: Dirk M Elston, MD  more...
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Medication

Medication Summary

The chemotherapeutic regimen chosen depends on the subtype of leukemia. B-cell leukemia can be treated with rituximab containing chemotherapy regimen. An extensive discussion of specific chemotherapeutic protocols can be found in Medscape Drugs & Diseases articles on the individual type of leukemia. The listing below includes some of the common chemotherapeutic drugs used to treat acute leukemia.

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Antineoplastic agents

Class Summary

These agents inhibit cell proliferation.

Daunorubicin hydrochloride (Cerubidine)

Daunorubicin hydrochloride inhibits DNA and RNA synthesis by intercalating between DNA base pairs. Daunorubicin is rapidly and widely distributed in the tissues (distribution half-life is 2 min) following IV infusion. It is metabolized extensively by the liver.

Idarubicin hydrochloride (Idamycin)

Idarubicin inhibits cell proliferation by inhibiting DNA and RNA polymerase.

Cytarabine (Cytosar-U)

Cytarabine is converted intracellularly to active compound cytarabine-5'-triphosphate, which inhibits DNA polymerase.

Tretinoin (Vesanoid)

Tretinoin is an all-trans -retinoic acid derived from naturally occurring all-trans -retinol (vitamin A-1). Oral tretinoin is more than 95% bound to plasma proteins and is metabolized by cytochrome P450 enzymes in liver.

Arsenic trioxide (Trisenox)

Arsenic trioxide is used to treat patients with APL whose conditions have relapsed or are refractory to retinoid or anthracycline chemotherapy. It may cause DNA fragmentation and damage or degrade fusion protein PML-RAR alpha in APL.

Etoposide (VePesid, Toposar)

Etoposide is administered as combination salvage chemotherapy in patients with relapsed AML. It inhibits topoisomerase II and causes DNA strand breakage, causing cell proliferation to arrest in the late S or early G2 portion of the cell cycle.

Methotrexate (Folex PFS, Rheumatrex)

Methotrexate is an antimetabolite that inhibits dihydrofolate reductase, thereby hindering DNA synthesis and cell reproduction in malignant cells. It is administered as combination salvage therapy for relapse.

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Growth factors

Class Summary

These agents are indicated in patients receiving chemotherapy with signs of infection and neutropenia.

Sargramostim (Leukine)

Sargramostim is a GM-CSF that stimulates division and maturation of earlier myeloid and macrophage precursor cells.

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Uricosuric agents

Class Summary

These agents increase the renal clearance of uric acid by inhibiting the renal tubular reabsorption of uric acid.

Allopurinol (Zyloprim)

Allopurinol inhibits xanthine oxidase, the enzyme that synthesizes uric acid from hypoxanthine. It reduces the synthesis of uric acid without disrupting the biosynthesis of vital purines.

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