Cancer drugs A to Z list
Liposomal daunorubicin and cytarabine is a type of chemotherapy combination. It is also known as CPX351 and L-DA.
You pronounce daunorubicin as daw-noh-roo-bih-sin and cytarabine as sye-ta-ra-bin.
This is a treatment for acute myeloid leukaemia (AML).
Treatment for acute myeloid leukaemia (AML)
Daunorubicin and cytarabine are both types of chemotherapy.
Daunorubicin works by destroying quickly dividing cells, such as cancer cells. This helps to stop the cancer growing.
Cytarabine is a type of chemotherapy drug called an . It kills cancer cells by stopping them from making and repairing DNA that they need to grow and multiply.
Liposomal means that these chemotherapy drugs are ‘wrapped up’ in a fatty covering called liposome. This helps to keep the drugs in the bloodstream longer, so that more of the drug reaches the cancer cells. It also causes less severe side effects.
You have liposomal daunorubicin and cytarabine as a drip into your bloodstream (intravenously).
You might have treatment through a long plastic tube that goes into a large vein in your chest. The tube stays in place throughout the course of treatment. This can be a:
central line
PICC line
portacath
Read more about having medicine into your bloodstream
You have liposomal daunorubicin and cytarabine as cycles of treatment. This means that you have the drugs and then a rest to allow your body to recover.
Each cycle of treatment lasts 28 days (4 weeks). You may start your next cycle the following day. Or you may need to wait until your have recovered. This can vary from person to person.
You have up to 2 cycles to get rid of the leukaemia cells (induction treatment). After the first cycle you have a bone marrow test to check how well the treatment has worked.
You have your first cycle of treatment in the following way:
Induction cycle 1
On day 1, 3 and 5 you have liposomal daunorubicin and cytarabine as a drip into your bloodstream over 90 minutes.
Some people may have a second induction cycle, you have this in the following way:
Induction cycle 2
On day 1 and 3 you have liposomal daunorubicin and cytarabine as a drip into your bloodstream over 90 minutes.
About 5 to 8 weeks after induction treatment you may have up to 2 cycles of consolidation treatment with the same drugs. This is to lower the risk of leukaemia coming back. You have consolidation treatment in the following way:
Consolidation cycles
On day 1 and 3 you have liposomal daunorubicin and cytarabine as a drip into your bloodstream over 90 minutes.
You have blood tests before and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.
You also have heart tests such as an ECHO, ECG or both before treatment. You may continue to have heart tests during and after treatment with these drugs.
Side effects can vary from person to person. They also depend on what other treatments you're having.
Your doctor, nurse or pharmacist will go through the possible side effects. They will monitor you during treatment and check how you are at your appointments. Contact your advice line as soon as possible if:
you have severe side effects
your side effects aren’t getting any better
your side effects are getting worse
Early treatment can help manage side effects better.
We haven't listed all the side effects here. Talk to your healthcare team if you have any new symptoms that you think might be a side effect of your treatment.
Remember it is very unlikely that you will have all of these side effects. But you might have some of them at the same time.
These side effects happen in more than 10 in 100 people (more than 10%). You might have one or more of them. They include:
Increased risk of getting an infection is due to a drop in white blood cells. Symptoms include a change in temperature, aching muscles, cough, headaches, feeling cold and shivery, pain or a burning feeling when peeing, or generally feeling unwell. You might have other symptoms depending on where the infection is.
Infections can sometimes be life threatening. You should contact your advice line urgently if you think you have an infection.
A reaction may happen during the infusion. Symptoms can include a skin rash, itching, swelling of the lips, face or throat, breathing difficulties, fever and chills. Your nurse will give you medicines beforehand to try to prevent a reaction.
If you have difficulty sleeping, it can help to change a few things about how you try to sleep. Try to go to bed and get up at the same time each day and spend some time relaxing before you go to bed. Some light exercise each day may also help.
You may have mood changes that mean you feel anxious or confused. Tell your doctor of nurse if you are finding it difficult to cope.
Let your doctor or nurse know if you have headaches. They can give you painkillers such as paracetamol to help.
This drug might make you feel dizzy. Don’t drive or operate machinery if you have this.
You might have blurred vision or other changes. It usually temporary, speak to your doctor, nurse of pharmacist if you are worried about this.
You may have changes to how your heart works such as your heart rhythm may be fast, slow or irregular. Some people might also develop chest pain. Let your healthcare team know if you have this or any other symptoms such as shortness of breath, feeling lightheaded or dizzy.
You usually have heart tests before you start this treatment.
During treatment, your blood pressure may be lower or higher than normal. Tell your nurse if you feel dizzy, faint, or if you have headaches, nosebleeds, blurred or double vision, or shortness of breath. Your blood pressure usually goes back to normal while you are on treatment or when treatment ends.
Tell your doctor or nurse if you are short of breath or you have a cough. This could be due to a collection of fluid around the lung (pleural effusion) or it may be for another reason.
Feeling or being sick is usually well controlled with anti sickness medicines. It might help to avoid fatty or fried foods, eat small meals and snacks and take regular sips of water. Relaxation techniques might also help.
It is important to take anti sickness medicines as prescribed even if you don’t feel sick. It is easier to prevent sickness rather than treat it once it has started.
It may be painful to swallow drinks or food. Painkillers and mouth washes can help to reduce the soreness and keep your mouth healthy.
Tell your healthcare team if you have diarrhoea or constipation. They can give you medicine to help.
You might notice skin changes, such as reddening of the skin, itching, or rashes.
Rarely, the skin on your hands and feet may become sore, red, or may peel. You may also have tingling, numbness, pain and dryness. This is called hand-foot syndrome or palmar plantar syndrome.
Tell your healthcare team if you have any skin changes. They might be able to give you a medicine or something to help like a cream or lotion.
This drug might cause you to sweat more than usual. But there are ways to reduce sweating. Less commonly you might have night sweats. Let your healthcare team know if you are sweating much more than normal.
It is common with this drug to have pain in areas such as your tummy (abdomen), muscles, bones, or joints. Speak to your doctor or nurse about what painkillers you can take to help with this.
Liposomal daunorubicin and cytarabine can affect how well your kidneys work. You have regular blood tests to check how well they are working.
Let your healthcare team know if you have breathlessness, tiredness, itchy skin, confused, fluid build up especially around the hands or ankles.
You might feel very tired and as though you lack energy.
Various things can help you to reduce tiredness and cope with it, for example exercise. Some research has shown that taking gentle exercise can give you more energy. It is important to balance exercise with resting.
A build up of fluid may cause swelling in your arms, hands, ankles, legs, face and other parts of the body. Contact your healthcare team if this happens to you.
You might get a high temperature. Or you might feel cold or start shivering (chills).
These side effects happen in between 1 and 10 out of every 100 people (between 1 and 10%). You might have one or more of them. They include:
low levels of in your blood (anaemia), this can make you feel weak and tired
low levels of – this can increase the risk of bleeding
changes to the levels of chemicals in your blood due to the breakdown of tumour cells (tumour lysis syndrome) - you have regular blood tests to check for this
hair loss
Indigestion, symptoms include heartburn, bloating and burping
We have more information about side effects and tips on how to cope with them.
Read more about how to cope with side effects
Cancer drugs can interact with medicines, herbal products, and some food and drinks. We are unable to list all the possible interactions that may happen. An example is grapefruit or grapefruit juice which can increase the side effects of certain drugs.
Tell your healthcare team about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies. Also let them know about any other medical conditions or allergies you may have.
It is not known whether this treatment affects in people. Talk to your doctor before starting treatment if you think you may want to have a baby in the future.
This treatment may harm a baby developing in the womb. It is important not to become pregnant or get someone pregnant while you're having treatment and for at least 6 months afterwards.
Talk to your doctor or nurse about effective contraception before starting treatment. Let them know straight away if you or your partner become pregnant while having treatment.
It is not known whether this drug comes through into the breast milk. Doctors usually advise that you don’t breastfeed during this treatment.
If you are having tests or treatment for anything else, always mention your cancer treatment. For example, if you are visiting your dentist.
Don’t have immunisations with live vaccines while you’re having treatment and for up to 12 months afterwards. The length of time depends on the treatment you are having.
Ask your doctor or pharmacist how long you should avoid live vaccinations.
In the UK, live vaccines include rubella, mumps, measles, BCG, and yellow fever.
You can usually have:
other vaccines, but they might not give you as much protection as usual
the flu vaccine (as an injection)
the coronavirus (COVID-19) vaccine
Talk to your doctor or pharmacist about the best time to have a vaccine in relation to your cancer treatment.
You can be in contact with other people who have had live vaccines as injections. If someone has had a live vaccine by mouth or nasal spray there may be a small risk the vaccine virus can be passed onto you if your is weakened.
Your healthcare team will let you know if you need to take any precautions if you are in close contact with someone who has had a live vaccine.
Read more about immunisations and cancer treatment
For further information about this treatment and possible side effects go to the electronic Medicines Compendium (eMC) website. You can find the patient information leaflet on this website.
You can report any side effect you have to the Medicines and Healthcare products Regulatory Agency (MHRA) as part of their Yellow Card Scheme.
Last reviewed: 16 Apr 2024
Next review due: 16 Apr 2027
AML starts from young white blood cells called granulocytes or monocytes in the bone marrow. Find out about symptoms, how it is diagnosed and treated, and how to cope.
Find out more about Chemotherapy for acute myeloid leukaemia (AML)
Chemotherapy works by killing cancer cells and has different effects on different types of cancer. You might have a combination of different chemotherapy drugs.
Cancer drugs have side effects and these can vary from person to person. But there are things that you can do to help you cope.
Coping with cancer can be difficult. There is help and support available. Find out about the emotional, physical and practical effects of cancer and how to manage them.
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