An anthracenedione chemotherapy
Mitoxantrone
A chemotherapy medicine used for some leukaemias and prostate cancer, and occasionally for aggressive multiple sclerosis.
What is Mitoxantrone?
Mitoxantrone is a specialist chemotherapy medicine used to treat some leukaemias and advanced prostate cancer, and occasionally to control aggressive multiple sclerosis. It is given as an injection into a vein under the care of a specialist team. The most important concerns are that it can cause cumulative damage to the heart muscle and raise the risk of a second leukaemia later, as well as lowering the blood counts and turning the urine a harmless blue-green colour. Because of these risks, the total amount a person can have over their lifetime is carefully limited and monitored.
Education and reference only. This is a plain-language guide to Mitoxantrone — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Mitoxantrone is a chemotherapy medicine, of a type called an anthracenedione, used in hospital to treat certain cancers — particularly some leukaemias and advanced prostate cancer — and, less commonly, to slow down very active or aggressive multiple sclerosis. It is given as an injection into a vein by a specialist team. It is a powerful treatment with important risks, so it is used carefully, with close monitoring and limits on the total amount a person can receive over their lifetime to protect the heart.
How it works
Mitoxantrone works by getting in the way of the DNA inside cells, which stops fast-growing cells from dividing and multiplying. In cancer this slows or stops the growth of the abnormal cells. In multiple sclerosis it is thought to help by dampening down an overactive immune system that attacks the nervous system. Because it affects rapidly dividing cells throughout the body, it also affects healthy ones such as those in the bone marrow, which is why it lowers blood counts and needs careful monitoring.
Company & origin
Originated / developed by: Specialist manufacturers.
A specialist chemotherapy medicine used in UK hospitals for certain cancers and, occasionally, for aggressive multiple sclerosis.
Practical use
How to take Mitoxantrone
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- It is given as an injection into a vein by a specialist team; you do not take it yourself.
- Attend all your appointments for blood tests and heart checks, as these guide safe treatment.
- Do not be alarmed if your urine turns blue-green for a day or two; this is harmless.
- Report any breathlessness, ankle swelling, signs of infection, unusual bruising or bleeding promptly.
- Use reliable contraception as advised, as it can harm an unborn baby, and discuss fertility before starting.
Weighing it up
Advantages & disadvantages of Mitoxantrone
Advantages
- An effective treatment for some leukaemias and advanced prostate cancer.
- Can help slow very active or aggressive multiple sclerosis when other options are unsuitable.
- Given as a relatively short injection into a vein under specialist care.
Disadvantages
- Can cause cumulative damage to the heart muscle, so the total lifetime amount is strictly limited.
- Raises the risk of developing a second leukaemia years later.
- Lowers the blood counts, increasing the risk of infection, bleeding and tiredness.
Practical use
Good to know
The dominant issue with mitoxantrone is that it can cause cumulative damage to the heart muscle, meaning the risk grows the more a person receives over time; for this reason the heart is checked before and during treatment and there is a strict limit on the total lifetime amount. A second major concern is a raised risk of developing a different leukaemia years later. Like other chemotherapy, it lowers the blood counts, increasing the risk of infection, bleeding and tiredness, so blood tests are done regularly. A harmless but striking effect is that it turns the urine, and sometimes the whites of the eyes, a blue-green colour for a day or two. It is a specialist treatment used only under expert supervision.
Who should not take it / use with caution
- People who have had a serious allergic reaction to mitoxantrone should not be given it.
- It must not be used in pregnancy, as it can seriously harm an unborn baby.
- It is used with great caution, or avoided, in people with significant heart problems or already low blood counts.
Monitoring
- Heart checks before and during treatment, with a strict limit on the total lifetime amount given.
- Regular blood tests to check blood counts and liver function.
- Watching for signs of heart problems, infection and, over the long term, a second leukaemia.
Side effects
- Lowered blood counts, leading to a higher risk of infection, bruising, bleeding and tiredness.
- A harmless blue-green colour to the urine, and sometimes the whites of the eyes, for a day or two.
- Nausea, hair thinning, mouth soreness and a higher chance of infection.
- More seriously, damage to the heart muscle and, rarely, a second leukaemia developing later.
Key interactions
- It adds to the effects of other medicines that lower blood counts or affect the immune system.
- Other medicines that can affect the heart may add to the risk of heart damage.
- Live vaccines are generally avoided during treatment; tell your team about all your medicines and vaccines.
Available as: A solution for injection into a vein, given in hospital.
Answers
Mitoxantrone: frequently asked questions
What is mitoxantrone used for?
It is a chemotherapy medicine used for some leukaemias and advanced prostate cancer, and occasionally to slow very active or aggressive multiple sclerosis.
Why is the total amount I can have limited?
Mitoxantrone can cause cumulative damage to the heart muscle, so there is a strict limit on the total amount you can receive over your lifetime to protect your heart.
Why has my urine turned blue-green?
A blue-green colour to the urine, and sometimes the whites of the eyes, for a day or two is a harmless and expected effect of mitoxantrone.
Does it raise the risk of another cancer?
Yes, it can raise the risk of developing a different leukaemia years later, which is one reason it is used carefully and only when the benefits outweigh the risks.
Why do I need so many blood tests?
It lowers the blood counts, increasing the risk of infection and bleeding, so regular blood tests are used to check your counts and keep treatment safe.
The wider class
About Anthracenedione chemotherapy
Mitoxantrone belongs to the anthracenedione chemotherapy class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
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Authoritative sources
- BNF
- NICE CKS
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