Amsacrine is an antitumor agent used to treat adult acute leukemia. It is no longer commercially available in the United States, although it is available in Canada.
Amsacrine is an investigational drug used to treat refractory acute lymphocytic and nonlymphocytic leukemias, Hodgkin's disease, and non-Hodgkin's lymphomas. It may also have some activity against head and neck cancers.
Amsacrine inhibits the synthesis of DNA. It also inhibits the enzyme responsible for cutting the strands of DNA, and untwists DNA so that replication of DNA can't occur.
The dose for amsacrine may be different depending on the protocol used by the physician. The drug is given through the vein as a 30-to 90-minute infusion or as a 24-hour continuous infusion. Example doses for adults are: 60 to 160 mg per square meter of body surface area every three to four weeks, or 40 to 120 mg per square meter of body surface area for five to seven days every three to four weeks. The dose for children is 120 to 150 mg per square meter of body surface area per day for five days. The dose of amsacrine is usually decreased in patients with decreased kidney or liver function.
Amsacrine is usually given with caution to patients with underlying heart disease, severe kidney or liver disease, or to patients who have received high doses of anthracycline chemotherapy drugs, such as doxorubicin.
Although the effects of amsacrine treatment on children are currently unknown, caution is still indicated. Women of childbearing age should take precautions to prevent pregnancy while on this drug. Women should not breastfeed while taking this medication.
Toxicity to the heart is a common side effect of amsacrine, and patients receiving this drug are usually very closely monitored by their physician. Other common side effects of amsacrine include nausea and vomiting, diarrhea, ulcerations of the mouth and the gastrointestinal tract, decreased white blood cells and platelets, and decreased liver function. Patients may notice orange-red discoloration of the urine, but should not be alarmed as this is normal. The urine will clear again once all the drugs have been eliminated from the body. Other common side effects include headache, dizziness, confusion, seizures, abnormal touch sensation such as burning and prickling, and blurred vision. As with any side effects that occur while taking any medications, patients should notify their doctor or nurse immediately.
To prevent any drug interactions, patients should consult their physician, nurse, or pharmacist prior to taking any over-the-counter medications, herbal medications, or new medications. Many physicians recommend bringing the containers with the names of the drugs to an appointment.
Michael V. Zuck, Ph.D.