Nelarabine
Mechanism :
Nelarabine, a prodrug of ara-G, is demethylated by adenosine deaminase to ara-G and then converted to ara-GTP. Ara-GTP is incorporated into the DNA of the leukemic blasts, leading to inhibition of DNA synthesis and inducing apoptosis.
Indication :
- Treatment of relapsed or refractory T-cell acute lymphoblastic leukemia/lymphoma following at least 2 chemotherapy regimens.
Contraindications :
Hypersensitivity to nelarabine or any component of the formulation.
Dosing :
IV:
650 mg/m²/dose on days 1 through 5; repeat every 21 days.
Adverse Effect :
Anemia, neutropenia, thrombocytopenia, fatigue, headache, peripheral neurologic disorder, hypoesthesia, paresthesia, pain, asthenia, fever, edema, petechiae, cough, dyspnea, pleural effusion, diarrhea, nausea, vomiting, myalgia, seizures, Fatal opportunistic infections, Demyelination and ascending peripheral neuropathies.
Interaction :
Clozapine: Myelosuppressive Agents may enhance the adverse/toxic effect of Clozapine.
Deferiprone: Myelosuppressive Agents may enhance the neutropenic effect of Deferiprone.
Pentostatin: May diminish the antineoplastic effect of Nelarabine.
Vaccines (Live): Immunosuppressants may enhance the adverse/toxic effect of live vaccines.
Hepatic Dose :
No dose adjustments are recommended.