[.
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Action/Kinetics:
By inhibiting both DNA synthesis and repair, toxicity occurs to both actively dividing and quiescent lymphocytes and monocytes. Results in accumulation of 2-chloro-2'-deoxy-beta-
d-adenosine monophosphate (2-CdAMP), which is subsequently converted to the active triphosphate deoxynucleotide (2-CdATP). Cells with high deoxycytidine kinase and low deoxynucleotidase activities (as in lymphocytes and monocytes) will be selectively killed as toxic deoxynucleotides accumulate intracellularly.
t
1/2: 5.4 hr. Excreted mainly through the urine.
Uses:
Hairy cell leukemia as defined by clinically significant anemia, neutropenia, thrombocytopenia, or disease-related symptoms.
Investigational: Advanced cutaneous T-cell lymphomas; chronic lymphocytic leukemia; non-Hodgkin's lymphomas; acute myeloid leukemia; autoimmune hemolytic anemia; mycosis fungoides or the Sezary syndrome.
Contraindications:
Lactation.
Special Concerns:
Use with caution in clients with known or suspected renal or hepatic insufficiency. Benzyl alcohol, a constituent of the 7-day infusion solution, has been associated with a fatal ``gasping syndrome'' in premature infants. Although used in children, safety and efficacy have not been established.
Side Effects:
Hematologic: Neutropenia, anemia, thrombocytopenia, prolonged depression of CD
4 counts, prolonged bone marrow hypocellularity.
Body as a whole: Fever, infections (including septicemia, pneumonia), fatigue, chills, asthenia, diaphoresis, malaise, trunk pain.
GI: Nausea, decreased appetite, vomiting, diarrhea, constipation, abdominal pain.
CV: Edema, tachycardia, purpura, petechiae, epistaxis.
CNS: Headache, dizziness, insomnia.
Dermatologic: Rashes, reactions at injection site, pruritus, pain, erythema.
Respiratory: Abnormal breath sounds, cough, abnormal chest sounds, SOB.
Musculoskeletal: Myalgia, arthralgia.
Following IV injection: Redness, swelling pain, thrombosis, phlebitis.
Overdose Management:
Symptoms: Irreversible neurologic toxicity (paraparesis/quadriparesis),
acute nephrotoxicity, severe bone marrow suppression.
Treatment: Discontinue infusion of the drug. Institute appropriate supportive measures as there is no antidote for cladribine.
How Supplied:
Injection: 1 mg/mL
Dosage
?IV infusion
Hairy cell leukemia.
A single course given by continuous infusion for 7 consecutive days at a dose of 0.09 mg/kg/day.
