mitoxantron

Mitoxantron is a synthetic anthracenedione drug used in chemotherapy and as an immunomodulator. Its chemical structure is related to anthracyclines, though it lacks the sugar moiety. Mitoxantron works by intercalating into DNA, thereby inhibiting DNA replication and transcription, and also by inhibiting the enzyme topoisomerase II, which is essential for DNA repair. This dual mechanism leads to cell death, particularly in rapidly dividing cancer cells.

In oncology, mitoxantron is employed in the treatment of various cancers, including metastatic breast cancer, acute myeloid leukemia, and advanced prostate cancer. It is often used in combination with other chemotherapy agents. Its use in certain types of lymphoma and non-Hodgkin's lymphoma has also been documented.

Beyond its anticancer properties, mitoxantron is also used to manage the symptoms of secondary progressive multiple sclerosis (SPMS), relapsing-remitting multiple sclerosis (RRMS), and progressive relapsing multiple sclerosis (PRMS). In this context, it acts as an immunosuppressant, reducing the frequency and severity of relapses and slowing disease progression by suppressing immune cell activity that attacks the myelin sheath protecting nerve fibers.

Mitoxantron is administered intravenously. Common side effects include nausea, vomiting, hair loss, and a blue-gray discoloration of the skin, eyes, and urine. A significant potential side effect is cardiotoxicity, which can be cumulative and dose-dependent. Therefore, careful monitoring of cardiac function is crucial during treatment. Its use is contraindicated in patients with severe myelosuppression or hypersensitivity to the drug.