Mitoxantrone (chemotherapy agent)

Mitoxantrone is a chemotherapy drug that bears some chemical similarities with the anthracyclines doxorubicin and daunorubicin. However, mitoxantrone was developed with a view towards achieving efficacy similar to the anthracyclines but without the cardiotoxicity closely associated with that drug class.

Drug profile

  • Class: Synthetic anthracenedione antibiotic
  • Mechanism of action: Mitoxantrone is a type II topoisomerase inhibitor, meaning it prevents DNA from synthesizing during mitosis and also prevents the cell from repairing the DNA.
  • Treatment type: Chemotherapy
  • US approval: 1987
  • Synonyms: Novantrone, DHAD
  • FDA Use-in-Pregnancy Rating: Category D

What Mitoxantrone is effective for and why

Mitoxantrone is used against a handful of cancers, including acute myeloid leukemia (with cytarabine), prostate cancer (with prednisone), hepatocellular carcinoma and breast cancer. It is also included in a salvage chemotherapy regimen (MVC) for relapsed or refractory Hodgkins lymphoma, as well as the CNOP and FN-D regimens for certain cases of non-Hodgkins lymphoma.

Side effects: Overview

While each patient will have his or her own experiences with the side effects of mitoxantrone, most patients will likely experience myelosuppression (leukopenia), nausea and/or vomiting, stomatitis, diarrhea, anorexia, and elevated liver function (evident in blood tests). Despite being an anthracycline, cardiotoxicity is dose-dependent and considered rare. Most if not all of these side effects should subside when one is finished with receiving mitoxantrone. Patients are encouraged to report all side effects to their oncologist or oncology team.


  • Boyiadzis, Michael M. et al. Hematology-Oncology Therapy. 2007. New York: McGraw Hill, Medical Publishing Division.
  • Cancer Drug Manual, BC Cancer Agency
  • Perry, Michael C, Editor. Companion Handbook to the Chemotherapy Sourcebook. 1999. Baltimore; Williams & Wilkins.
  • Mitoxantrone

Significant studies relating to mitoxantrone


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