Cytarabine

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Cytosine arabinoside (Cytarabine) and cytarabine ocfosfate (prodrug) are mitotic inhibitor (antimetabolite) chemotherapy drugs.

Although this drug is mainly used for treatment of leukemia[1], it crosses the blood-brain barrier in normal dogs and intravenous administration has the potential as a treatment modality for neoplasia involving the CNS of dogs[2].

Cytarabine is primarily used for treatment of canine acute megakaryoblastic[3] and acute myelomonocytic leukemia[4] but has been used for treatment of myelodysplasia[5] and granulomatous meningoencephalomyelitis[6] every three weeks in conjunction with prednisolone.

A number of reports have detailed the use of this drug in multidrug chemotherapy for multicentric lymphoma, such as the COAP (cyclophosphamide, vincristine, cytarabine, prednisolone)[7] and DMAC schedules (dexamethasone, melphalan, actinomycin D and cytoarabine)[8], with variable results.

Complications of use include calcinosis cutis at injection site[9].

This drug can be given subcutaneously at 50 - 100 mg/m2 or as a constant rate infusion intravenously at 25 mg/m2 per hour, with a 7-day washout before receiving the alternative treatments[10].

References

  1. Rohrig KE (1983) Acute myelomonocytic leukemia in a dog. J Am Vet Med Assoc 182(2):137-141
  2. Scott-Moncrieff JC et al (1991) Plasma and cerebrospinal fluid pharmacokinetics of cytosine arabinoside in dogs. Cancer Chemother Pharmacol 29(1):13-18
  3. Willmann M et al (2009) Chemotherapy in canine acute megakaryoblastic leukemia: a case report and review of the literature. In Vivo 23(6):911-918
  4. Hisasue M et al (2008) A dog with acute myelomonocytic leukemia. J Vet Med Sci 70(6):619-621
  5. Ide K et al (2003) A severe hepatic disorder with myelodysplastic syndrome, treated with cytarabine ocfosfate, in a dog. Aust Vet J 81(1-2):47-49
  6. Menaut P et al (2008) Treatment of 11 dogs with meningoencephalomyelitis of unknown origin with a combination of prednisolone and cytosine arabinoside. Vet Rec 162(8):241-245
  7. Hosoya K et al (2007) Comparison of COAP and UW-19 protocols for dogs with multicentric lymphoma. J Vet Intern Med 21(6):1355-1363
  8. Alvarez FJ et al (2006) Dexamethasone, melphalan, actinomycin D, cytosine arabinoside (DMAC) protocol for dogs with relapsed lymphoma. J Vet Intern Med 20(5):1178-1183
  9. Volk AV et al (2012) Calcinosis cutis at cytarabine injection site in three dogs receiving prednisolone. Vet Rec 171(13):327
  10. Crook KI et al (2012) The pharmacokinetics of cytarabine in dogs when administered via subcutaneous and continuous intravenous infusion routes. J Vet Pharmacol Ther Sep 3