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This type of chemotherapy can treat several types of cancer, but it can cause a range of side effects. Anthracycline drugs are among the most effective anticancer drugs. Doctors use them to treat a variety of cancers, including leukemia, lymphoma, breast cancer, and many metastatic cancers. Although they are effective, anthracyclines can cause various side effects ranging from mild to severe. This article explains how anthracyclines work, the side effects they can cause, and more. How do anthracycline drugs work Share on PinterestFatCamera/Getty ImagesAnthracyclines are anti-tumor drugs made from the Streptomyces bacterium. They are antibiotics. However, doctors do not use them to treat infections in the same way they use other antibiotics. Anthracyclines work by damaging the DNA in cancer cells and interfering with their ability to reproduce. The drugs bind with DNA to prevent cancer cells from reproducing. Anthracycline drugs may affect several mechanisms, including: free radical formationlipid peroxidationdirect membrane effectsenzyme interactions Types of anthracycline drugs All anthracyclines are extracted from the Streptomyces bacterium. However, each has a slightly different chemical composition. Doctors select anthracycline drugs based on the type of cancer cells they want to target and how potent they need to be. Anthracyclines include: Daunorubicin Cerubidine Doctors prescribe daunorubicin for certain types of acute myeloid leukemia (AML) and acute lymphocytic leukemia (ALL). Doxorubicin Adriamycin Doxorubicin is suitable for use in combination with other medications. It can treat many cancers, including certain types of lung, bladder, breast, stomach, and ovarian cancer. Epirubicin Ellence Doctors prescribe epirubicin alongside other medications to treat breast cancer in people who have already had surgery to remove the tumor. Mitoxantrone Novantrone The primary use for mitoxantrone is to treat multiple sclerosis. It is also suitable for treating certain types of leukemia alongside other medications. Valrubicin Valstar Valrubicin treats bladder cancer in patients who are not eligible for surgery right away. Idarubicin Idamycin PFS Idarubicin can treat AML in adults, and researchers are studying its use for other types of cancer. What is the procedure for anthracycline chemotherapy A person usually takes anthracyclines by injection or intravenous infusion. Some drugs are inserted directly into the bladder to treat bladder cancer. Each treatment session could last a few minutes up to several hours. The kind of cancer and its stage will impact the dosage and administration. For example, treatment might be daily for 2 weeks, with a week off for the body to regenerate cells. The cycle may then repeat. Each clinician will determine their patient’s proper dosing and administration schedule based on individual needs. Side effects from anthracycline chemotherapy Side effects of anthracycline chemotherapy can range from mild to severe. A person can talk with a doctor about the side effects they may experience from their drug regimen. Common anthracycline side effects include:chillsitchy skinnauseavomitinginfectiondiarrheaconstipationurine discolorationabdominal painloss of appetite or weightunusual tiredness or weakness Sometimes, drugs can leak from a vein into surrounding tissue, causing irritation and pain. A healthcare professional will monitor the administration site closely for a reaction. If a person notices the following symptoms, they should call a doctor right away:painitchingswellingrednessblisterssores Anthracyclines may alter the way the heart functions during treatment or for months to years afterward. Before and during treatment, doctors will order tests to monitor the heart’s ability to pump blood. If a person’s heart function decreases, they may not be able to have the treatment. Another side effect of anthracyclines is a decrease in blood cells in a person’s bone marrow. This may cause symptoms such as bleeding and bruising more easily than usual, becoming anemic, and being more prone to infection. A person should call a doctor immediately if they have any of the following symptoms:feversore throatsigns of infectioncough or congestionunusual bleeding or bruisingbloody, black, or tarry stoolvomiting blood or brown material that looks like coffee grounds Long-term risks of anthracycline chemotherapy The use of anthracyclines increases a person’s risk of developing other serious conditions at a later date. The risk is cumulative, which means that the more anthracyclines a person receives, and the longer and more intense the treatment, the more their risk increases. For this reason, there is a maximum lifetime cumulative dose for anthracyclines. Doctors will take this into account when deciding on a person’s treatment. Cardiotoxicity Anthracyclines can induce cardiotoxicity, which causes damage to the heart’s structures and functions. A person may develop symptoms of heart damage during chemotherapy treatment or in the months and years afterward. Doctors have no way of identifying people at risk of cardiotoxicity beyond considering factors such as age and pre-existing cardiovascular conditions. People who take anthracyclines are 57% more likely to develop heart problems than people who do not. They are also 8.2 times more likely to die as a result of heart issues. Secondary cancers Anthracyclines also increase the risk of a person developing other types of cancer. Secondary cancers linked to anthracycline use include: AMLmyelodysplastic syndrome (MDS)ALLbreast cancer How effective is anthracycline chemotherapy Different types of cancer have different survival rates so generalizing about the success of anthracyclines is not possible. Some studies have looked at the impact of anthracyclines on specific cancer types. One study focused on women treated with chemotherapy following surgery to remove early-stage, HER2-negative breast cancer with a high risk of recurrence. Of 4,130 women in the study, 2052 received anthracycline chemotherapy while 2,078 received non-anthracycline treatment. After around 3 years, those treated with anthracyclines fared slightly better than the non-anthracycline group. 92.4% of the anthracycline group were still alive and cancer-free after 3 years, compared to 91.7% of the other group. Many factors can impact the success of treatment, including a person’s age, general health, and cancer stage. Summary Anthracycline chemotherapy drugs derive from the Streptomyces bacterium, and doctors use them to treat a variety of cancers. They are some of the most successful cancer-fighting drugs available. The drugs work by binding with DNA in cancer cells and preventing them from reproducing. Anthracylines can cause a range of side effects. Mild side effects include nausea, chills, and vomiting. More serious side effects include changes in heart function and a decrease in bone marrow blood cells. Anthracyclines increase a person’s chance of developing heart problems and secondary cancers later on. Doctors take this into account when deciding on treatment. Many factors can influence the effectiveness of cancer treatment, such as age, cancer stage, and general health. A person can talk with a doctor about their outlook and chances of successful treatment. Last medically reviewed on June 28, 2022Cancer / OncologyDrugs 11 sourcescollapsedMedical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.Anthracycline chemo regimen seems better than regimen without anthracycline for early-stage, HER2-negative, high-risk disease. (2016).https://www.breastcancer.org/research-news/chemo-w-anthracycline-better-for-someAnthracyclines side effects and late effects. (n.d.).https://idc-online.com/technical_references/pdfs/chemical_engineering/Anthracyclines_Side_Effects_and_Late_Effects.pdfDaunorubicin. (2022.) .https://pubchem.ncbi.nlm.nih.gov/compound/DaunorubicinDoxorubicin. (2022).https://pubchem.ncbi.nlm.nih.gov/compound/31703Epirubicin. (2022).https://pubchem.ncbi.nlm.nih.gov/compound/41867#section=Drug-and-Medication-InformationIdarubicin 10 mg/10 ml solution for injection. (2021).https://www.medicines.org.uk/emc/product/775/smpcIdarubicin hydrochloride. (2021).https://pubchem.ncbi.nlm.nih.gov/compound/636362Kim, H., et al. (2019). Risk factor analysis for secondary malignancy in dexrazoxane-treated pediatric cancer patients.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6333985/#b2-crt-2017-457Second cancers related to treatment. (2020).https://www.cancer.org/treatment/survivorship-during-and-after-treatment/long-term-health-concerns/second-cancers-in-adults/treatment-risks.htmlValrubicin. (2018).https://www.cancer.gov/about-cancer/treatment/drugs/valrubicinVenkateah, P., et al. (2022). Anthracyclines.https://www.ncbi.nlm.nih.gov/books/NBK538187/FEEDBACK:Medically reviewed by Faith Selchick, DNP, AOCNP, Nursing, Oncology — By Karen Veazey on June 28, 2022 Latest newsWhat sets 'SuperAgers' apart? Their unusually large neuronsOmega-3 may provide a brain boost for people in midlifeSeasonal affective disorder (SAD): How to beat it this fall and winterCDC: Monkeypox in the US 'unlikely to be eliminated in the near future'Why are more women prone to Alzheimer's? New clues arise Related CoverageIs chemotherapy painful? What to know Chemotherapy can result in pain during and after a person receives it. Learn more about the side effects and how it feels to have chemotherapy here.READ MOREWhat are the side effects of chemotherapy? Some common side effects of chemotherapy include infection, bleeding easily, hair loss, and nausea or vomiting. 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