Low dose ara-C administered by continuous subcutaneous infusion: a pharmacologic evaluation

Area of Science:

• Oncology
• Pharmacology
• Hematology

Background:

• Low-dose cytarabine (ara-C) is a standard treatment for preleukemia and leukemia.
• Current administration methods include twice-daily subcutaneous bolus or continuous intravenous infusion.
• Logistical challenges exist with long-term intravenous infusions.

Purpose of the Study:

• To investigate the pharmacology of continuous subcutaneous infusion of ara-C.
• To evaluate its feasibility as an alternative to intravenous administration.
• To compare plasma levels and myelosuppression with existing methods.

Main Methods:

• Administered ara-C at 20 mg/M2/d via continuous subcutaneous infusion in eight patients.
• Measured steady-state plasma ara-C levels.
• Monitored for myelosuppression.

Main Results:

• Achieved steady-state plasma ara-C levels comparable to intravenous infusions (24.6-65.6 nM vs. 26.2-61.5 nM).
• Observed prolonged myelosuppression similar to continuous intravenous infusions.
• Demonstrated the feasibility of subcutaneous administration.

Conclusions:

• Continuous subcutaneous infusion of low-dose ara-C is a viable treatment option.
• This method offers advantages over intravenous infusions, reducing the need for catheters or hospitalization.
• It provides a practical alternative for outpatient treatment of preleukemia and leukemia.