Clofarabine

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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

  1. abdominal pain
  2. agitation
  3. anemia
  4. anorexia
  5. anxiety
  6. arthralgia
  7. asthenia
  8. back pain
  9. bleeding
  10. bone pain
  11. bowel necrosis
  12. bullous rash
  13. candidiasis
  14. capillary leak syndrome
  15. chills
  16. colitis
  17. diarrhea
  18. drowsiness
  19. dyspnea
  20. edema
  21. elevated hepatic enzymes
  22. enterocolitis
  23. epistaxis
  24. erythema
  25. fatigue
  26. fever
  27. flushing
  28. GI bleeding
  29. GI perforation
  30. headache
  31. hematuria
  32. hematuria
  33. hepatic failure
  34. hepatitis
  35. hyperbilirubinemia
  36. hypertension
  37. hyperuricemia
  38. hyponatremia
  39. hypotension
  40. infection
  41. influenza
  42. intracranial bleeding
  43. irritability
  44. jaundice
  45. lethargy
  46. leukopenia
  47. lymphopenia
  48. myalgia
  49. nausea
  50. neutropenia
  51. palmar-plantar erythrodysesthesia (hand and foot syndrome)
  52. pancreatitis
  53. pericardial effusion
  54. petechiae
  55. pleural effusion
  56. pruritus
  57. pulmonary edema
  58. rash
  59. renal failure (unspecified)
  60. sinus tachycardia
  61. sinusitis
  62. sinusoidal obstruction syndrome (SOS)
  63. Stevens-Johnson syndrome
  64. stomatitis
  65. tachypnea
  66. thrombocytopenia
  67. toxic epidermal necrolysis
  68. tumor lysis syndrome (TLS)
  69. veno-occlusive disease (VOD)
  70. 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

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