Cytarabine is a cancer medication that interferes with the growth and spread of cancer cells in the body.
1. Dosing instructions
1) Use cytarabine administered, patients should be appropriately increased fluid intake , so maintain an alkaline urine , if necessary, can be combined with allopurinol to prevent bleeding increased uric acid and uric acid nephropathy.
2) Rapid intravenous injection -induced nausea and vomiting reaction is far more serious, but less severe bone marrow suppression , patients are generally able to withstand .
3) intravenous infusion solution should be diluted to 0.5mg/ml.
4) reconstituted injection at 4 ℃ ( refrigerator ) stored for 7 days at room temperature for 24 hours only .
5) intrathecal medication, the diluent should be free of preservatives.
6) using the dose or high-dose cytarabine therapy, some patients may occur serious gastrointestinal and nervous system adverse reactions, such as gastrointestinal ulcers , gastrointestinal cystic gas , necrotizing enterocolitis, around neuropathy, brain or cerebellar dysfunction , such as personality changes, hypotonia , epilepsy , lethargy , coma , disorientation , nystagmus , dysarthria , ataxia ; still occur hemorrhagic conjunctivitis , skin rashes , hair loss, peeling , severe cardiac disease.
7) where there is a variety of serious adverse reactions, should be discontinued immediately , and immediately take effective measures to treatment. Some patients given corticosteroids may reduce the dose or high-dose cytarabine induced adverse reactions.
2. Dosage
1 ) Adult usage:
(1) acute leukemia induction therapy : often combined with other chemotherapy drugs , each 1 ~ 3mg/kg, intravenous , q 12h, once every 5 to 7 days. Repeated at intervals of 1 to 2 weeks .
(2) medium and large reduction therapy : used in refractory or relapsed acute leukemia or acute leukemia in remission after intensive treatment . The mean dose per 500 ~ 1000mg/m2, intravenous infusion of 1 to 3 hours , q12h, 2 ~ 6 day of a course of treatment. Each dose refers to the 1000 ~ 3000mg/m2, usage with the dosing regimen . Because cytarabine adverse reactions increases with the dose increased , large doses but affect its efficacy , it is now more in favor of using dosage regimens .
(3) subcutaneous injection : Each 10mg/m2, q12h, 14 ~ 21 day of a course of treatment. If the patient does not alleviate the situation allows , may be repeated after 2 to 3 weeks a course . This scheme can be used blasts myelodysplastic syndrome, low proliferative leukemia, elderly patients with acute non-lymphocytic leukemia.
(4) intrathecal injection : meningeal leukemia , each 25 ~ 75mg, plus dexamethasone 5mg, dissolved intrathecal injection of NS , 1 or 2 times a week , with the normal to the cerebrospinal fluid examination . Prophylaxis for every four to eight times a week .
2) Children’s usage:
Acute leukemia induction therapy , 100mg / (m2 • d), once every 5 to 7 days.
3. Adverse Reaction
1) Digestive system: common loss of appetite, nausea , vomiting , diarrhea, gastritis , stomatitis and gastrointestinal ulcers. Some patients had abnormal liver function, high bilirubin and aminotransferase . Large doses may appear obvious abnormal liver function and jaundice , can cause liver lobule central vein and venous occlusion , resulting in jaundice , hepatomegaly, ascites and hepatic encephalopathy.
2) Blood system: bone marrow suppression increases with the dose increased , the performance of white blood cells, thrombocytopenia.
3) Local reactions : pain at the infusion thrombophlebitis and mostly subsided after discontinuation , there are also other reactions itching and rash ; local ophthalmic drugs , often cause temporary burning, itching and other mild irritation, tears may also occur , foreign body sensation , conjunctival hyperemia , superficial punctate keratitis , pain, photophobia and other reactions.
4) Central nervous system : occasional discomfort , fatigue, tremors, dizziness , hallucinations, psychotic symptoms and confusion, its occurrence and dose-related , usually subside after discontinuation , there are reports of headache and encephalopathy , which is often difficult with the primary disease phase identification , occurs in the liver and kidney dysfunction .
5) Than the amount of the performance : Daily intake of cytarabine doses greater than 20mg/kg, can cause bone marrow suppression ; event than the amount of medication, need to closely monitor the blood system and liver and kidney function .
6) Other adverse reactions: common temporary alanine aminotransferase increased, occasionally serum total bilirubin . There dizziness , fever , hair loss , rash , etc., can also lead to male reproductive dysfunction . Who are allergic to the chemicals , pregnant and lactating women disabled. WBC and platelet counts decreased significantly with biliary tract disease , history of gout or urate history of kidney stones , recently received cytotoxic drugs or radiation therapy, liver and kidney dysfunction with caution.
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