II. Indications
- FDA Approved
- Off-Label Use
- Acute Myelogenous Leukemia (adults and children)
- Advanced Cutaneous T Cell Lymphoma
- Autoimmune Hemolytic Anemia
- Chronic Lymphocytic Leukemia (CLL)
- Langerhans Cell Histiocytosis (children)
- Multiple Sclerosis (progressive)
- Non-Hodgkin Lymphoma
- Sezary Syndrome
- Waldenstrom's Macroglobulinemia
III. Mechanism
- Purine Nucleoside antimetabolite analog
- Cladribine is metabolized intracellularly to 2-CdATP (Cladribine triphosphate, an active metabolite)
- 2-CdATP incorporates into DNA
- Results in DNA single strand breaks
- Also depletes energy molecules
- Selectively more toxic to cancerous Lymphocytes and Monocytes
- Cladribine is resistant to Adenosine deaminase (therefore selective for Lymphocytes and Monocytes)
- Noncancerous Lymphocytes and Monocytes are less responsive to Cladribine
IV. Medications
- IV Solution: 10 mg per 10 ml vials
V. Dosing
- See other references for disease specific dosing protocols
VI. Adverse Effects
VII. Safety
- Avoid in Pregnancy (any trimester)
- Use reliable Contraception
- Avoid in Lactation
- Monitoring