Cytarabine Injection

• Type: Chemotherapy medication

• Drug Class: Antimetabolite (pyrimidine analog)

• Form: Sterile solution or powder for reconstitution, given intravenously (IV), subcutaneously (SC), or intrathecally (into spinal fluid)

How It Works

• Cytarabine is structurally similar to cytidine, a building block of DNA.

• Once inside cells, it is converted to its active form, which gets incorporated into DNA.

• This blocks DNA synthesis and repair, leading to cell death, especially in rapidly dividing cancer cells.

Common Uses

Cytarabine is a key drug in the treatment of blood cancers:

• Acute Myeloid Leukemia (AML) – cornerstone of induction and consolidation therapy

• Acute Lymphoblastic Leukemia (ALL) – in some regimens

• Chronic Myeloid Leukemia (CML) – in blast crisis

• Lymphomas – especially in central nervous system (CNS) prophylaxis or treatment

• Meningeal leukemia/lymphoma – given intrathecally to treat or prevent CNS involvement

Advantages

• Highly effective in killing leukemia and lymphoma cells

• Can cross into cerebrospinal fluid (especially when given intrathecally), making it valuable for CNS treatment

• Can be used in different dosing regimens (standard-dose, intermediate-dose, or high-dose protocols) depending on disease severity

Possible Side Effects

Cytarabine has dose-related side effects, especially at higher doses:

Common

• Bone marrow suppression (low white cells, red cells, and platelets)

• Nausea, vomiting, diarrhea

• Mouth sores (mucositis)

• Fever, flu-like symptoms

High-Dose Side Effects

• Eye irritation or conjunctivitis (prevented with steroid eye drops)

• Cerebellar toxicity (difficulty with coordination, speech, or balance) – usually reversible but requires close monitoring

• Liver function abnormalities

Other

• Rash

• Hair loss

• Rare: allergic reactions

Precautions

• Frequent blood tests to monitor bone marrow function

• Eye drops are usually given with high-dose cytarabine to prevent eye damage

• Neurological exams before each dose at high-intensity regimens to catch toxicity early

• Use under close supervision in patients with liver or kidney problems (dose adjustment may be needed)