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b**isantrene + cytarabine** is an investigational intravenous combination regimen being developed primarily for use in adult patients with relapsed or refractory acute myeloid leukemia (AML), especially those with extramedullary disease and able to tolerate intensive chemotherapy. Bisantrene is an anthracene-derived topoisomerase II inhibitor, developed as a less cardiotoxic alternative to anthracyclines; cytarabine is a nucleoside analog antimetabolite that inhibits DNA synthesis. The combination aims to enhance antileukemic efficacy by combining two mechanisms: DNA intercalation/topoisomerase II inhibition (bisantrene) and inhibition of DNA synthesis (cytarabine). Preclinical and early clinical studies suggest potential activity in difficult-to-treat AML subsets, especially those with extramedullary disease[1][2][3].
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