Amsacrine (AMSA P-D™) is, like mitoxantrone, a totally synthetic drug, the intercalating properties of which are due to the three plane chromophore rings. Its action is mainly due to inhibition of topo-isomerase II.
The main indications are:
Acute leukaemia lymphocytic or myelocytic
(after relapse or inefficiency of the other treatment)
This product should be used in strictly IV infusion: it is highly toxic for the venous endothelium.
The usual dosage is from 90 to 200 mg/m2 each day, for 5 consecutive days.
Only specific toxicities (or major toxicities) are described here. Other common chemotherapy toxicities are described in the chapter on chemotherapy toxicity.
They may be very severe. Thus, for these relapsing patients, precise knowledge of this product and strict patient follow-up are mandatory.
Either the classical cardiomyopathy observed for antracyclines depending on previously administered anthracyclines,
or, quite often, various rhythm modifications, some of them major, such as supraventricular fibrillation or tachycardia.
Stomatitis and diarrhoea may be very severe.
Extravasation leads to major necrosis.