Hydroxyrurea acts by suppressing dihydrophosphate reductase, an enzyme that reduces ribonucleotides into deoxyribonucleotides necessary for DNA synthesis.

This drug causes a sharp increase in the amount of white blood cells in severe leukemias. It is used for leukemias, meanomas, and carcinomas. Synonyms of this drug are litalir, hydrea, onco-carbide, and others.

Mitoxantrone: Mitoxantrone, 1,4-dihydroxy-5,8-bis[[2-[(2-hydroxyethyl) amino) ethyl]amino]]-9,10-anthracendione (30.6.3), is structurally related to the antibiotic dox-orubicine. It is synthesized from danthron (1,8-dihydroxyanthraquinone), which when reacted with nitric acid, and then a mixture of sodium sulfide and thiosulfate in a base, is transformed to 1,4,5,8-tetrahydroxyanthraquinone (30.6.2). Reacting this with 2-amino-ethylaminoethanol in the presence of chloranyl (2,3,5,6-tetrachlorobenzoquinone-1,4) gives the desired mitoxantrone (30.6.3), [142-145].

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