Idarubicin is a new derivative of
Daunorubicin which was found to be more potent and more active than
Daunorubicin and
Doxorubicin in several
experimental leukemias. Its antileukemic activity in preclinical models prompted the introduction of
Idarubicin into clinical studies. As a single agent,
Idarubicin produced complete remission in 20% and 30% of patients with heavily pretreated pediatric and adult
acute myeloid leukemia (AML) and
acute lymphoblastic leukemia (ALL) respectively.
Idarubicin combined with
Cytarabine and/or other antileukemic agents produced complete remissions in 46% of patients with refractory or relapsed AML and in 58% of patients with refractory or relapsed ALL (adult and pediatric). Subsequently,
Idarubicin has been employed in untreated AML patients in combination with
Cytarabine and/or
Etoposide, producing complete remissions in more than 80% of patients. In ALL patients the
drug has been used in combination with
Vincristine,
Cytarabine and
Prednisone, producing complete remissions in 82% of patients. Recently,
Idarubicin has been utilized in combination with intermediate doses of
Cytarabine in refractory or relapsed ALL and AML, and 70% of patients achieved complete remission. Preliminary results of ongoing prospective randomized studies in untreated adult AML seem indicate that
Idarubicin is at least equivalent, if not superior to
Daunorubicin. The antileukemic activity of
Idarubicin given orally as single agent, or in combination with other drugs, has been shown in AML and
myelodysplastic syndromes. The toxicity of
Idarubicin includes mild
nausea and
vomiting,
alopecia and
liver dysfunction. Ongoing randomized trials comparing
Idarubicin to
Daunorubicin should provide more information about the potential
cardiotoxicity of this
drug.