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Clofarabine

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Information about Clofarabine

Clofarabine is a purine analogue and antineoplastic agent used in the therapy of acute lymphoblastic leukemia (ALL) in children.

Liver safety of Clofarabine

Clofarabine is associated with frequent transient serum enzyme elevations during therapy, but they are usually asymptomatic and transient and it has only rarely been implicated in causing clinically apparent acute liver injury with jaundice.

Mechanism of action of Clofarabine

Clofarabine (kloe far' a been) is a purine analogue that is used in the treatment of acute lymphoblastic leukemia (ALL) in children and is used off-label in other forms of leukemia and myelodysplastic syndromes. Clofarabine is a fluorinated arabinosyladenine derivative that is converted intracellularly to the active triphosphate, which is believed to compete with adenine triphosphate for uptake and use by DNA polymerase leading to inhibition of DNA synthesis.

FDA approval information for Clofarabine

Clofarabine was found to have activity against acute leukemia and was approved for use as an antineoplastic agent in the United States in 2004. Current indications are therapy of acute lymphoblastic leukemia in children after failure of prior therapies.

Dosage and administration for Clofarabine

Clofarabine is available as a powder for injection generically and under the trade name Clolar. The typical pediatric dose for ALL is 52 mg/m2 intravenously once daily for 5 days, with repeat courses every 2 to 6 weeks.

Side effects of Clofarabine

Common side effects include bone marrow suppression, leucopenia, infections, fever, nausea, vomiting, anorexia, diarrhea, headache, fatigue, mucositis and skin rash. Clofarabine has been associated with rare instances of capillary leak syndrome marked by hypotension, tachypnea, edema, and progressive pulmonary and renal failure which is frequently fatal. Corticosteroids are typically given with clofarabine to help prevent this syndrome.


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