Is Mitoxantrone Safe in Breastfeeding

I am a breastfeeding mother and i want to know if it is safe to use Mitoxantrone? Is Mitoxantrone safe for nursing mother and child? Does Mitoxantrone extracts into breast milk? Does Mitoxantrone has any long term or short term side effects on infants? Can Mitoxantrone influence milk supply or can Mitoxantrone decrease milk supply in lactating mothers?

Drug is cleared from the body in 3-5 elimination half-lives. Resuming breastfeeding is likely safe after 2 - 3 months of of pumping-and-dumping.

Most sources consider breastfeeding to be contraindicated during maternal antineoplastic drug therapy, such as mitoxantrone.[1][2] It might be possible to breastfeed safely during intermittent therapy with an appropriate period of breastfeeding abstinence, but the duration of abstinence is not clear. In one patient, mitoxantrone was still detectable in milk 28 days after a dose of 6 mg per square meter. Chemotherapy may adversely affect the normal microbiome and chemical makeup of breastmilk.[3] Women who receive chemotherapy during pregnancy are more likely to have difficulty nursing their infant.[4]

One mother received 3 daily doses of 6 mg/sq m of mitoxantrone intravenously along with 5 daily doses of etoposide 80 mg/sq m and cytarabine 170 mg/sq m intravenously. She resumed breastfeeding her infant 3 weeks after the third dose of mitoxantrone at a time when mitoxantrone was still detectable in milk. The infant had no apparent abnormalities at 16 months of age.[3]