Cladribine

Information about Cladribine

Cladribine is a purine analogue and antineoplastic agent used primarily in the therapy of hairy cell leukemia.

Liver safety of Cladribine

Cladribine is typically given intravenously daily for 7 days, usually as a single course, and has not been associated with serum enzyme elevations during therapy or with instances of clinically apparent acute liver injury with jaundice.

Mechanism of action of Cladribine

Cladribine (klad' ri been) is a purine analogue (2-chlorodeoxyadeosine) that is used predominantly in the treatment of hairy cell leukemia. Cladribine is a chlorodinated derivative of adenine which is converted intracellularly to the cladribine triphosphate, which is believed to compete with adenine triphosphate in DNA synthesis. Cladribine was found to have marked activity against hairy leukemia and was approved for this use in the United States in 1993. Cladribine has been used off-label to treat low grade lymphomas and other hematologic malignancies, but its current formal indications are limited to therapy of active hairy cell leukemia.

Dosage and administration for Cladribine

Cladribine is available as a solution for injection generically and under the trade name Leustatin. The typical dose regimen is a single course of 0.9 mg/m2 intravenously once daily for 7 days. Repeat courses are recommended only for patients who had an initial response and later relapsed.

Side effects of Cladribine

Common side effects include bone marrow suppression, leucopenia, fever, infections, nausea, vomiting, anorexia, diarrhea, headache, fatigue and skin rash. In addition, opportunistic viral infections are common during the month after cladribine therapy and appropriate vaccination is recommended before its use. In high doses, above what is recommended for hairy cell leukemia, cladribine has been reported to have acute neurologic toxicity.

Antineoplastic Agents
Alkylating Agents - Altretamine, Bendamustine, Busulfan, Carmustine, Chlorambucil, Cyclophosphamide, Dacarbazine, Ifosfamide, Lomustine, Mechlorethamine, Melphalan, Procarbazine, Streptozocin, Temozolomide, Thiotepa, Trabectedin
Platinum Coordination Complexes - Carboplatin, Cisplatin, Oxaliplatin
Antibiotics Cytotoxic - Bleomycin, Dactinomycin, Daunorubicin, Doxorubicin, Epirubicin, Idarubicin, Mitomycin, Mitoxantrone, Plicamycin, Mithramycin, Valrubicin
Antimetabolites Antifolates - Methotrexate, Pemetrexed, Pralatrexate, Trimetrexate
Purine Analogues - Azathioprine, Cladribine, Clofarabine, Fludarabine, Mercaptopurine, Nelarabine, Pentostatin, Thioguanine
Pyrimidine Analogues - Azacitidine, Capecitabine, Cytarabine, Decitabine, Floxuridine, Fluorouracil, Gemcitabine, Trifluridine/Tipracil
Biologic Response Modifiers - Aldesleukin (IL-2), Denileukin Diftitox, Interferon gamma
Histone Deacetylase Inhibitors - Belinostat, Panobinostat, Romidepsin, Vorinostat
Hormonal Agents Antiandrogens - Abiraterone, Bicalutamide, Cyproterone, Enzalutamide, Flutamide, Nilutamide
Antiestrogens (including Aromatase Inhibitors) - Anastrozole, Exemestane, Fulvestrant, Letrozole
Selective Estrogen Receptor Modulators - Raloxifene, Tamoxifen, Toremifene
Gonadotropin Releasing Hormone Analogues - Degarelix, Goserelin, Histrelin, Leuprolide, Triptorelin
Peptide Hormones - Lanreotide, Octreotide, Pasireotide
Monoclonal Antibodies - Alemtuzumab, Atezolizumab, Avelumab, Bevacizumab, Blinatumomab, Brentuximab, Cetuximab, Daratumumab, Dinutuximab, Durvalumab, Elotuzumab, Gemtuzumab, Inotuzumab Ozogamicin, Ipilimumab, Necitumumab, Nivolumab, Ofatumumab, Olaratumab, Panitumumab, Pembrolizumab, Pertuzumab, Ramucirumab, Rituximab, Tositumomab, Trastuzumab
Protein Kinase Inhibitors - Abemaciclib, Acalabrutinib, Afatinib, Alectinib, Axitinib, Bortezomib, Bosutinib, Brigatinib, Cabozantinib, Carfilzomib, Ceritinib, Cobimetinib, Copanlisib, Crizotinib, Dabrafenib, Dasatinib, Enasidenib, Erlotinib, Gefitinib, Ibrutinib, Idelalisib, Imatinib, Ivosidenib, Ixazomib, Lapatinib, Lenvatinib, Neratinib, Nilotinib, Niraparib, Olaparib, Osimertinib, Palbociclib, Pazopanib, Ponatinib, Regorafenib, Ribociclib, Rucaparib, Ruxolitinib, Sonidegib, Sorafenib, Sunitinib, Trametinib, Vandetanib, Vemurafenib, Vismodegib
Taxanes - Cabazitaxel, Docetaxel, Paclitaxel
Topoisomerase Inhibitors - Etoposide, Irinotecan, Teniposide, Topotecan
Tyrosine Kinase Receptor Inhibitors See Protein Kinase Inhibitors
Vinca Alkaloids - Vinblastine, Vincristine, Vinorelbine
Miscellaneous - Asparaginase (Pegaspargase), Bexarotene, Eribulin, Everolimus, Hydroxyurea, Ixabepilone, Lenalidomide, Mitotane, Omacetaxine, Pomalidomide, Temsirolimus, Thalidomide, Venetoclax

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