Indications

• Acute Myeloid Leukemia (AML) (see Acute Myeloid Leukemia, [[Acute Myeloid Leukemia]]): prior to bone marrow transplant
• Non-Hodgkin’s Lymphoma (see Lymphoma, [[Lymphoma]])

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Pharmacology

• Pyrimidine Analog Which Impairs DNA Synthesis: specific for the S-phase of the cell cycle
  • Cytarabine is Rapidly Converted into Cytosine Arabinoside Triphosphate -> Cell Cycle is Held in the S Phase: impairs DNA synthesis
    • This most impacts rapidly dividing cells, which require DNA replication for mitosis
  • Cytarabine Inhibits DNA/RNA Polymerases and Nucleotide Reductase: these enzymes are required for DNA synthesis
• Inhibits Deoxycytidine Utilization: when used as an anti-viral

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Administration

• IV

Dose Adjustment

• Hepatic
• Renal

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Adverse Effects

Gastrointestinal Adverse Effects

• Acute Pancreatitis (see Acute Pancreatitis, [[Acute Pancreatitis]]): questionable association

Neurologic Adverse Effects

• Posterior Reversible Encephalopathy Syndrome (PRES) (see Posterior Reversible Encephalopathy Syndrome, [[Posterior Reversible Encephalopathy Syndrome]])

Pulmonary Adverse Effects

Acute Lung Injury-ARDS (see Acute Lung Injury-ARDS, [[Acute Lung Injury-ARDS]])

• Epidemiology: associated with intensive regimens
• Clinical
  • Timing of Onset
    • 13-28% developed their lung injury during ARA-C administration
    • 50% developed lung injury during within a month of completing ARA-C administration
• Treatment: supportive
• Prognosis: may be fatal

Other Adverse Effects

• xxx

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References

• xxx