Nelarabine Brand Name– Arranon
What is Nelarabine
Nelarabine is a cytotoxic purine nucleoside analog. It is indicated for the treatment of T-cell acute lymphoblastic leukemia (ALL) and T-cell lymphoblastic lymphoma in pediatric patients 1 year of age or older and adults with relapsed or refractory disease following at least 2 prior chemotherapy regimens.
Severe neurologic adverse reactions have been reported with nelarabine therapy; therefore, monitor patients closely.
Indications
- chronic lymphocytic leukemia (CLL)
- T-cell leukemia/lymphoma
For the treatment of T-cell leukemia/lymphoma
NOTE: The FDA has designated nelarabine as an orphan drug for the treatment of acute lymphoblastic leukemia and lymphoblastic lymphoma.
for the treatment of relapsed or refractory T-cell acute lymphoblastic leukemia (ALL) or T-cell lymphoblastic lymphoma following at least 2 prior chemotherapy regimens
Side Effects
- abdominal pain
- abdominal pain
- amnesia
- anemia
- anemia
- anorexia
- aphasia
- arthralgia
- arthralgia
- asthenia
- asthenia
- ataxia
- ataxia
- back pain
- blurred vision
- chest pain (unspecified)
- chills
- coma
- confusion
- confusion
- constipation
- constipation
- cough
- dehydration
- dehydration
- depression
- depression
- diarrhea
- diarrhea
- dizziness
- drowsiness
- drowsiness
- dysarthria
- dysesthesia
- dysgeusia
- dyspnea
- dyspnea
- edema
- elevated hepatic enzymes
- elevated hepatic enzymes
- encephalopathy
- epistaxis
- fatigue
- fatigue
- fever
- fever
- Guillain-Barre syndrome
- headache
- headache
- hydrocephalus
- hyperbilirubinemia
- hyperbilirubinemia
- hyperglycemia
- hyperglycemia
- hypertonia
- hyperuricemia
- hypoalbuminemia
- hypoalbuminemia
- hypocalcemia
- hypocalcemia
- hypoesthesia
- hypoesthesia
- hypoglycemia
- hypoglycemia
- hypokalemia
- hypokalemia
- hypomagnesemia
- hypomagnesemia
- hyporeflexia
- hypotension
- hypotension
- infection
- infection
- insomnia
- intracranial bleeding
- lethargy
- leukoencephalopathy
- leukopenia
- leukopenia
- muscle paralysis
- myalgia
- myalgia
- nausea
- neuropathic pain
- neurotoxicity
- neurotoxicity
- neutropenia
- neutropenia
- nystagmus
- paresis
- paresthesias
- paresthesias
- peripheral edema
- peripheral neuropathy
- peripheral neuropathy
- petechiae
- petechiae
- pleural effusion
- pneumothorax
- rhabdomyolysis
- seizures
- sinus tachycardia
- sinus tachycardia
- sinusitis
- sinusitis
- stomatitis
- stomatitis
- thrombocytopenia
- thrombocytopenia
- tremor
- tumor lysis syndrome (TLS)
- vomiting
- vomiting
- weakness
- weakness
- wheezing
Monitoring Parameters
- CBC with differential
- neurologic function
- pregnancy testing
- serum creatinine
- serum electrolytes
- serum uric acid
Contraindications
- anemia
- breast-feeding
- children
- contraception requirements
- driving or operating machinery
- geriatric
- hepatic disease
- hyperuricemia
- male-mediated teratogenicity
- neurologic events
- neurotoxicity
- neutropenia
- pregnancy
- pregnancy testing
- radiation therapy
- renal disease
- renal impairment
- reproductive risk
- thrombocytopenia
- tumor lysis syndrome (TLS)
- vaccination
Interactions
- Abciximab
- Amlodipine; Celecoxib
- Anagrelide
- Anticoagulants
- Aspirin, ASA; Dipyridamole
- Azelastine; Fluticasone
- Bacillus Calmette-Guerin Vaccine, BCG
- Beclomethasone
- Betamethasone
- Budesonide
- Budesonide; Formoterol
- Celecoxib
- Ciclesonide
- Cilostazol
- Clopidogrel
- Clozapine
- Corticosteroids
- Cortisone
- Deflazacort
- Dexamethasone
- Diclofenac
- Diclofenac; Misoprostol
- Diflunisal
- Digoxin
- Diphenhydramine; Ibuprofen
- Diphenhydramine; Naproxen
- Dipyridamole
- Eptifibatide
- Esomeprazole; Naproxen
- Etodolac
- Famotidine; Ibuprofen
- Febuxostat
- Fenoprofen
- Filgrastim, G-CSF
- Fludrocortisone
- Flunisolide
- Flurbiprofen
- Fluticasone
- Fluticasone; Salmeterol
- Fluticasone; Umeclidinium; Vilanterol
- Fluticasone; Vilanterol
- Formoterol; Mometasone
- Hydrocodone; Ibuprofen
- Hydrocortisone
- Ibuprofen
- Ibuprofen; Oxycodone
- Ibuprofen; Pseudoephedrine
- Indomethacin
- Influenza Virus Vaccine
- Intranasal Influenza Vaccine
- Ketoprofen
- Ketorolac
- Lansoprazole; Naproxen
- Live Vaccines
- Measles Virus; Mumps Virus; Rubella Virus; Varicella Virus Vaccine, Live
- Measles/Mumps/Rubella Vaccines, MMR
- Meclofenamate Sodium
- Mefenamic Acid
- Meloxicam
- Methylprednisolone
- Mometasone
- Nabumetone
- Naproxen
- Naproxen; Pseudoephedrine
- Naproxen; Sumatriptan
- Nonsteroidal antiinflammatory drugs
- Oxaprozin
- Palifermin
- Pegfilgrastim
- Penicillamine
- Piroxicam
- Platelet Inhibitors
- Prasugrel
- Prednisolone
- Prednisone
- Rofecoxib
- Rotavirus Vaccine
- Rubella Virus Vaccine Live
- Smallpox and Monkeypox Vaccine, Live, Nonreplicating
- Smallpox Vaccine, Vaccinia Vaccine
- Sulindac
- Tbo-Filgrastim
- Ticagrelor
- Ticlopidine
- Tirofiban
- Tolmetin
- Triamcinolone
- Tuberculin Purified Protein Derivative, PPD
- Typhoid Vaccine
- Valdecoxib
- Varicella-Zoster Virus Vaccine, Live
- Vorapaxar
- Yellow Fever Vaccine, Live