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Systemic Anti-Cancer Therapy Regimen Library

LEU AML - MidAC [mitoxantrone and cytarabine]

Treatment Overview

Frequency: Every 28 days or on count recovery.

Number of courses: 1.

Cycle 1 - 28 days

Cycle length:
28

Cycle details

Cycle 1 - 28 days

Medication Dose Route Days Max Duration
mitoxantrone * 10 mg/m² Once daily intravenous 1 to 5 30 minutes
cytarabine 1000 mg/m² Twice daily intravenous 1, 2, 3 120 minutes
prednisolone acetate 1% (10 mg/mL) eye drops * 1 Drop Every four hours application to the eye 1 to 5

Full details

Cycle 1 - 28 days

Day: 1

Medication Dose Route Max duration Details
mitoxantrone * 10 mg/m² Once daily intravenous 30 minutes
cytarabine 1000 mg/m² Twice daily intravenous 120 minutes
Instructions:

Every 12 hours.

prednisolone acetate 1% (10 mg/mL) eye drops * 1 Drop Every four hours application to the eye
Instructions:

Instil ONE drop into each eye every FOUR hours on days 1 to 5.

Day: 2

Medication Dose Route Max duration Details
mitoxantrone * 10 mg/m² Once daily intravenous 30 minutes
cytarabine 1000 mg/m² Twice daily intravenous 120 minutes
Instructions:

Every 12 hours.

prednisolone acetate 1% (10 mg/mL) eye drops * 1 Drop Every four hours application to the eye
Instructions:

Instil ONE drop into each eye every FOUR hours on days 1 to 5.

Day: 3

Medication Dose Route Max duration Details
mitoxantrone * 10 mg/m² Once daily intravenous 30 minutes
cytarabine 1000 mg/m² Twice daily intravenous 120 minutes
Instructions:

Every 12 hours.

prednisolone acetate 1% (10 mg/mL) eye drops * 1 Drop Every four hours application to the eye
Instructions:

Instil ONE drop into each eye every FOUR hours on days 1 to 5.

Day: 4

Medication Dose Route Max duration Details
mitoxantrone * 10 mg/m² Once daily intravenous 30 minutes
prednisolone acetate 1% (10 mg/mL) eye drops * 1 Drop Every four hours application to the eye
Instructions:

Instil ONE drop into each eye every FOUR hours on days 1 to 5.

Day: 5

Medication Dose Route Max duration Details
mitoxantrone * 10 mg/m² Once daily intravenous 30 minutes
prednisolone acetate 1% (10 mg/mL) eye drops * 1 Drop Every four hours application to the eye
Instructions:

Instil ONE drop into each eye every FOUR hours on days 1 to 5.

Supportive Care Factors

Factor Value
Antifungal prophylaxis: Routine antifungal prophylaxis recommended
Antiviral prophylaxis for herpes virus: Routine antiviral prophylaxis recommended
Emetogenicity: Variable
Ocular toxicity risk: High - administer corticosteroid eyedrops to minimise corneal toxicity

Antiviral prophylaxis for hepatitis B virus: Guidance is limited to high-risk anti-cancer medicines. Clinicians will need to assess individual patient risk for other anti-cancer medicines. 

Emetogenicity: MEDIUM days 1 to 3, LOW days 4 and 5.

References

Burnett AK, Russell NH, Hills RK, Hunter AE, Kjeldsen L, Yin J, Gibson BE, Wheatley K, Milligan D. Optimization of chemotherapy for younger patients with acute myeloid leukemia: results of the medical research council AML15 trial. J Clin Oncol. 2013 Sep 20;31(27):3360-8. doi: 10.1200/JCO.2012.47.4874. Epub 2013 Aug 12., PMID: 23940227

AML15 protocol Version 2 January 2004 https://www.skion.nl/workspace/uploads/English-protocol-website-version.pdf (accessed 8 August 2022).

Baxter Healthcare Ltd ONKOTRONE Data sheet 22 October 2020 https://www.medsafe.govt.nz/profs/datasheet/o/Onkotroneinj.pdf (accessed 11 July 2022).

* The medicines, doses, combinations, and schedule in this treatment regimen have been carefully reviewed against international best practice guidelines by specialists in medical oncology around New Zealand and this advice has been accepted for publication by Te Aho o Te Kahu (the Cancer Control Agency). Sometimes medicines that are used in routine clinical practice have not been through a formal review process by the NZ Medicines Regulator Medsafe and are therefore considered unapproved or off-label. These medicines are legally able to be prescribed through sections 25 and 29 of the Medicines Act and by obtaining informed consent from patients. All treatment regimens listed on this website have been through robust peer review and are considered an accepted standard of care, whether prescribed through sections 25 or 29 or carrying formal Medsafe Approval.

s29: This symbol indicates that some formulations of the associated medicine are legally only able to be prescribed under section 29 of the Medicines Act. You can see which formulations are section 29 by hovering over the s29 symbol. You can access full medication details from the New Zealand Formulary by clicking on the medication name. Each clinician retains full responsibility for ensuring they have complied with all relevant obligations and requirements of section 29 including obtaining informed patient consent prior to prescribing the applicable medicine.