Clofarabine Brand Name– Clolar
What is Clofarabine
Clofarabine is a purine nucleoside antimetabolite that inhibits DNA synthesis. It is indicated for the treatment of pediatric patients aged 1 to 21 years with relapsed or refractory acute lymphoblastic leukemia (ALL) after at least 2 prior regimens.
The complete remission rate was 20% and the partial remission rate was 10% in 61 pediatric patients (median age, 12 years; range, 1 to 20 years) with refractory or relapsed acute lymphoblastic leukemia in a multicenter, phase II study.
The median duration of remission was 9.7 weeks; the overall survival time for all patients in this study was 13 weeks (range, 1 to 89 weeks).
Clofarabine was approved by the FDA in 2004.
Indications
- acute lymphocytic leukemia (ALL)
For the treatment of acute lymphocytic leukemia (ALL)
for the treatment of relapsed or refractory ALL after at least 2 prior regimens
Side Effects
- abdominal pain
- agitation
- anemia
- anorexia
- anxiety
- arthralgia
- asthenia
- back pain
- bleeding
- bone pain
- bowel necrosis
- bullous rash
- candidiasis
- capillary leak syndrome
- chills
- colitis
- diarrhea
- drowsiness
- dyspnea
- edema
- elevated hepatic enzymes
- enterocolitis
- epistaxis
- erythema
- fatigue
- fever
- flushing
- GI bleeding
- GI perforation
- headache
- hematuria
- hematuria
- hepatic failure
- hepatitis
- hyperbilirubinemia
- hypertension
- hyperuricemia
- hyponatremia
- hypotension
- infection
- influenza
- intracranial bleeding
- irritability
- jaundice
- lethargy
- leukopenia
- lymphopenia
- myalgia
- nausea
- neutropenia
- palmar-plantar erythrodysesthesia (hand and foot syndrome)
- pancreatitis
- pericardial effusion
- petechiae
- pleural effusion
- pruritus
- pulmonary edema
- rash
- renal failure (unspecified)
- sinus tachycardia
- sinusitis
- sinusoidal obstruction syndrome (SOS)
- Stevens-Johnson syndrome
- stomatitis
- tachypnea
- thrombocytopenia
- toxic epidermal necrolysis
- tumor lysis syndrome (TLS)
- veno-occlusive disease (VOD)
- vomiting
Monitoring Parameters
- CBC with differential
- fibrinogen
- LFTs
- partial thromboplastin time (PTT)
- pregnancy testing
- serum creatinine/BUN
- serum electrolytes
- serum uric acid
Contraindications
- anemia
- bleeding
- bone marrow suppression
- breast-feeding
- capillary leak syndrome
- colitis
- contraception requirements
- fungal infection
- GI bleeding
- hepatic disease
- herpes infection
- hyperuricemia
- hypotension
- infection
- infertility
- intracranial bleeding
- neutropenia
- pericardial effusion
- pleural effusion
- pregnancy
- pregnancy testing
- pulmonary bleeding
- pulmonary edema
- renal disease
- renal impairment
- reproductive risk
- sepsis
- serious rash
- tachycardia
- thrombocytopenia
- tumor lysis syndrome (TLS)
- vaccination
- viral infection
Interactions
- Abacavir; Lamivudine, 3TC; Zidovudine, ZDV
- Abciximab
- Acyclovir
- Adefovir
- Aldesleukin, IL-2
- Aliskiren; Valsartan
- Alogliptin; Metformin
- Alteplase
- Amikacin
- Amlodipine; Celecoxib
- Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
- Amlodipine; Valsartan
- Anagrelide
- Anticoagulants
- Antithrombin III
- Antithymocyte Globulin
- Apixaban
- Argatroban
- Aspirin, ASA; Dipyridamole
- Aspirin, ASA; Pravastatin
- Azelastine; Fluticasone
- Bacillus Calmette-Guerin Vaccine, BCG
- Beclomethasone
- Betamethasone
- Betrixaban
- Bivalirudin
- Bosentan
- Budesonide
- Budesonide; Formoterol
- Canagliflozin; Metformin
- Cefadroxil
- Cefazolin
- Celecoxib
- Cerivastatin
- Ciclesonide
- Cidofovir
- Cilostazol
- Cimetidine
- Clopidogrel
- Clozapine
- Colchicine; Probenecid
- Corticosteroids
- Cortisone
- Cyclosporine
- Cytarabine, ARA-C
- Dabigatran
- Dalteparin
- Danaparoid
- Dapagliflozin; Metformin
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Deflazacort
- Desipramine
- Desirudin
- Dexamethasone
- Dextromethorphan; Quinidine
- Diclofenac
- Diclofenac; Misoprostol
- Diflunisal
- Digoxin
- Diphenhydramine; Ibuprofen
- Diphenhydramine; Naproxen
- Dipyridamole
- Disopyramide
- Donepezil; Memantine
- Doravirine; Lamivudine; Tenofovir disoproxil fumarate
- Echinacea
- Edoxaban
- Efavirenz; Emtricitabine; Tenofovir
- Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Empagliflozin; Linagliptin; Metformin
- Empagliflozin; Metformin
- Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
- Emtricitabine; Tenofovir disoproxil fumarate
- Enoxaparin
- Eptifibatide
- Ertugliflozin; Metformin
- Esomeprazole; Naproxen
- Etodolac
- Famotidine; Ibuprofen
- Febuxostat
- Fenoprofen
- Filgrastim, G-CSF
- Fludrocortisone
- Flunisolide
- Flurbiprofen
- Fluticasone
- Fluticasone; Salmeterol
- Fluticasone; Umeclidinium; Vilanterol
- Fluticasone; Vilanterol
- Fondaparinux
- Formoterol; Mometasone
- Foscarnet
- Gallium Ga 68 Dotatate
- Ganciclovir
- Gemfibrozil
- Gentamicin
- Glipizide; Metformin
- Glyburide; Metformin
- Heparin
- Hydrochlorothiazide, HCTZ; Valsartan
- Hydrocodone; Ibuprofen
- Hydrocortisone
- Ibuprofen
- Ibuprofen; Oxycodone
- Ibuprofen; Pseudoephedrine
- Indomethacin
- Influenza Virus Vaccine
- Intranasal Influenza Vaccine
- Ketoprofen
- Ketorolac
- Lamivudine, 3TC; Zidovudine, ZDV
- Lamivudine; Tenofovir Disoproxil Fumarate
- Lansoprazole; Naproxen
- Lepirudin
- Linagliptin; Metformin
- Live Vaccines
- Lopinavir; Ritonavir
- Mannitol
- Measles Virus; Mumps Virus; Rubella Virus; Varicella Virus Vaccine, Live
- Measles/Mumps/Rubella Vaccines, MMR
- Meclofenamate Sodium
- Mefenamic Acid
- Meloxicam
- Memantine
- Metformin
- Metformin; Pioglitazone
- Metformin; Repaglinide
- Metformin; Rosiglitazone
- Metformin; Saxagliptin
- Metformin; Sitagliptin
- Methotrexate
- Methylprednisolone
- Midazolam
- Mometasone
- Nabumetone
- Naproxen
- Naproxen; Pseudoephedrine
- Naproxen; Sumatriptan
- Nebivolol; Valsartan
- Neomycin
- Nonsteroidal antiinflammatory drugs
- Ombitasvir; Paritaprevir; Ritonavir
- Oxaprozin
- Palifermin
- Pegfilgrastim
- Penicillamine
- Pentamidine
- Pentosan
- Pentoxifylline
- Phenoxybenzamine
- Piroxicam
- Pitavastatin
- Platelet Inhibitors
- Prasugrel
- Pravastatin
- Prednisolone
- Prednisone
- Probenecid
- Quinidine
- Quinine
- Repaglinide
- Reteplase, r-PA
- Ritonavir
- Rivaroxaban
- Rofecoxib
- Rosuvastatin
- Rotavirus Vaccine
- Rubella Virus Vaccine Live
- Sacubitril; Valsartan
- Smallpox and Monkeypox Vaccine, Live, Nonreplicating
- Smallpox Vaccine, Vaccinia Vaccine
- Streptokinase
- Streptomycin
- Streptozocin
- Sulindac
- Tbo-Filgrastim
- Telaprevir
- Telithromycin
- Tenecteplase
- Tenofovir, PMPA
- Teriflunomide
- Thrombolytic Agents
- Ticagrelor
- Ticlopidine
- Tinzaparin
- Tirofiban
- Tobramycin
- Tolmetin
- Trandolapril; Verapamil
- Triamcinolone
- Tuberculin Purified Protein Derivative, PPD
- Typhoid Vaccine
- Urokinase
- Valdecoxib
- Valsartan
- Varicella-Zoster Virus Vaccine, Live
- Verapamil
- Vorapaxar
- Warfarin
- Yellow Fever Vaccine, Live
- Zidovudine, ZDV
