Mitomycin

Mitomycin (mitomycin C, Mitocin-C, Mutamycin) is an antibiotic that is derived from a species of Streptomyces. It is sometimes classified as an alkylating agent because it can covalently bind to and cross-link DNA. Mitomycin is thought to inhibit DNA synthesis through its ability to alkylate double-strand DNA and bring about interstrand cross-linking. There is evidence that enzymatic reduction by a reduced nicotinamide-adenine dinucleotide phosphate (NADPH) dependent reductase is necessary to activate the drug.

The drug is rapidly cleared from serum after intravenous injection but is not distributed to the brain.

Mitomycin has limited palliative effects in carcinomas of the stomach, pancreas, colon, breast, and cervix.

The major toxicity associated with mitomycin therapy is unpredictably long and cumulative myelosup-pression that affects both white blood cells and platelets. A syndrome of microangiopathic hemolytic anemia, thrombocytopenia, and renal failure also has been described. Renal, hepatic, and pulmonary toxicity may occur. The drug is teratogenic and carcinogenic, and it can cause local blistering.

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