ara-C in plasma and ara-CTP in leukemic cells after subcutaneous injection and continuous intravenous infusion of ara-C in patients with acute nonlymphoblastic leukemia. 1987

J O Liliemark, and G Gahrton, and C Y Paul, and C O Peterson

Six patients with acute nonlymphoblastic leukemia (ANLL) were treated sequentially with one subcutaneous (SC) injection (50 mg/m2) and one 156 hour continuous intravenous (IV) infusion (100 mg/m2/d) of 1-beta-D-arabinofuranosylcytosine (ara-C) with an interval of 12 hours. Leukemic cells were isolated from venous blood samples. The intracellular concentration of ara-C 5'-triphosphate (ara-CTP) was determined by high-performance liquid chromatography, and in two of the patients the plasma concentration of ara-C was determined by radioimmunoassay. A rapid biphasic elimination of the drug from plasma with an initial half-life of 18 minutes was seen after SC injection. After about 1.5 hours, the concentration was lower than that obtained at steady-state during continuous IV infusion. In the leukemic cells, the concentration of ara-CTP was higher after SC injection than during continuous IV infusion for about five hours. The mean half-life was 2.1 hours. Judging from the intracellular concentration of ara-CTP, considered to be the active metabolite, the results suggest that SC administration of ara-C can mimic continuous IV infusion if the dose interval is reduced from the traditional 12 hours to four to six hours. The results of this study emphasize the differences between the plasma pharmacokinetics of the parent drug and the concentration of the active metabolite in leukemic cells.

UI MeSH Term Description Entries
D007262 Infusions, Intravenous The long-term (minutes to hours) administration of a fluid into the vein through venipuncture, either by letting the fluid flow by gravity or by pumping it. Drip Infusions,Intravenous Drip,Intravenous Infusions,Drip Infusion,Drip, Intravenous,Infusion, Drip,Infusion, Intravenous,Infusions, Drip,Intravenous Infusion
D007279 Injections, Subcutaneous Forceful administration under the skin of liquid medication, nutrient, or other fluid through a hollow needle piercing the skin. Subcutaneous Injections,Injection, Subcutaneous,Subcutaneous Injection
D007938 Leukemia A progressive, malignant disease of the blood-forming organs, characterized by distorted proliferation and development of leukocytes and their precursors in the blood and bone marrow. Leukemias were originally termed acute or chronic based on life expectancy but now are classified according to cellular maturity. Acute leukemias consist of predominately immature cells; chronic leukemias are composed of more mature cells. (From The Merck Manual, 2006) Leucocythaemia,Leucocythemia,Leucocythaemias,Leucocythemias,Leukemias
D008297 Male Males
D008657 Metabolic Clearance Rate Volume of biological fluid completely cleared of drug metabolites as measured in unit time. Elimination occurs as a result of metabolic processes in the kidney, liver, saliva, sweat, intestine, heart, brain, or other site. Total Body Clearance Rate,Clearance Rate, Metabolic,Clearance Rates, Metabolic,Metabolic Clearance Rates,Rate, Metabolic Clearance,Rates, Metabolic Clearance
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D003561 Cytarabine A pyrimidine nucleoside analog that is used mainly in the treatment of leukemia, especially acute non-lymphoblastic leukemia. Cytarabine is an antimetabolite antineoplastic agent that inhibits the synthesis of DNA. Its actions are specific for the S phase of the cell cycle. It also has antiviral and immunosuppressant properties. (From Martindale, The Extra Pharmacopoeia, 30th ed, p472) Ara-C,Arabinofuranosylcytosine,Arabinosylcytosine,Cytosine Arabinoside,Aracytidine,Aracytine,Cytarabine Hydrochloride,Cytonal,Cytosar,Cytosar-U,beta-Ara C,Ara C,Arabinoside, Cytosine,Cytosar U,beta Ara C
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000208 Acute Disease Disease having a short and relatively severe course. Acute Diseases,Disease, Acute,Diseases, Acute

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