Daunomycin, an antitumor antibiotic, in the treatment of neoplastic disease.Clinical evaluation with special reference to childhood leukemia

TLDR

Daunomycin, an anthracycline antibiotic derived from *Streptomyces peucetius*, is associated with severe local reactions and bone marrow suppression. The study examines the distinct biological effects of daunomycin versus actinomycin D on DNA and RNA synthesis. Daunomycin is composed of daunomycinone linked to daunosamine via a glycosidic bond. In children with leukemia, a single course of daunomycin produced brief complete or partial remissions in 60 % of patients, with maintenance therapy prolonging remission, though the drug may cause cardiopulmonary toxicity, and it shows only temporary activity in neuroblastoma, reticulum cell sarcoma, and rhabdomyosarcoma.

Abstract

Daunomycin is a new antibiotic in the anthracycline group obtained from Streptomyces peucetius. It consists of a pigmented aglycone (daunomycinone) in glycoside linkage with an amino sugar (daunosamine). Differences in the biological effects of daunomycin, which reacts with DNA, and actinomycin D which complexes with DNA in a different manner to inhibit RNA production, are discussed. The toxic effects of daunomycin are a severe local reaction if the drug extravasates, bone marrow depression resulting in leucopenia, anemia, thrombocytopenia and bleeding, fever, oral ulcers and alopecia. In patients receiving maintenance doses of daunomycin the development of tachypnea, tachycardia pulmonary insufficiency, heart failure and hypotension possibly is associated with daunomycin but the evidence is unclear. Sixty per cent of children with leukemia obtained brief complete or partial hematological remissions from a single course of daunomycin. The remission could be prolonged by maintenance therapy. Daunomycin is temporarily effective in some cases of neuroblastoma, reticulum cell sarcoma and rhabdomyosarcoma.