Subcutaneous infusion of cytosine arabinoside. A practical alternative to intravenous infusion

The administration of cytosine arabinoside (araC) by continuous IV infusion requires the patient to be in hospital and have prolonged IV cannulation. In this study the pharmacokinetics of araC during continuous IV infusion were compared with those of continuous SC infusion in six patients with acute myelogenous leukaemia. Each patient acted as his own control. The mean plasma levels of araC reached a plateau within 2 h and the plasma concentrations and the area under the curve were similar for both methods of administration. The mean area under the curve (AUC) was 1147 +/- 230 ng/ml for the IV infusion and 1017 +/- 238 ng/ml for the SC infusion. The plasma araC concentrations showed wide interpatient variation, and there was also considerable variability in the plasma concentrations of araC within the individual patients after a plateau had apparently been reached. Subcutaneous infusion was well tolerated by the patients without any local discomfort or excoriation and SC infusion of araC is thus a feasible alternative to IV infusion. It allows the patients the benefits of being at home, while avoiding unnecessary thrombophlebitis.