II. Indications

  1. FDA Approved
    1. Acute Lymphoblastic Leukemia (refractory, age <=21 years)
  2. Off-Label Use
    1. Acute Lymphocytic Leukemia (refractory)
    2. Acute Myelogenous Leukemia (refractory)
    3. Langerhans Cell Histiocytosis (children)

III. Mechanism

  1. Antineoplastic Agent for Antimetabolite Chemotherapy
  2. Second generation purine Nucleoside analog
  3. Clofarabine triphosphate (an active metabolite) incorporates into DNA
    1. Results in inhibition of synthesis and repair of DNA
  4. Also disrupts mitochondrial function

IV. Medications

  1. IV Solution: 20 mg in 20 ml

V. Dosing

  1. See other references for disease specific dosing protocols
  2. Reduce dosing in moderate renal Impairment

VI. Adverse Effects

  1. Acute Kidney Injury
  2. Hepatitis or hepatic failure
  3. Myelodepression
  4. Myelodysplastic Syndrome
  5. Tumor Lysis Syndrome

VII. Safety

  1. Avoid in Pregnancy (any trimester)
    1. Use reliable Contraception
  2. Avoid in Lactation
  3. Monitoring
    1. Complete Blood Count
    2. Liver Function Tests
    3. Renal Function tests

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Related Studies

Ontology: clofarabine (C0092777)

Definition (NCI) A second generation purine nucleoside analog with antineoplastic activity. Clofarabine is phosphorylated intracellularly to the cytotoxic active 5'-triphosphate metabolite, which inhibits the enzymatic activities of ribonucleotide reductase and DNA polymerase, resulting in inhibition of DNA repair and synthesis of DNA and RNA. This nucleoside analog also disrupts mitochondrial function and membrane integrity, resulting in the release of pre-apoptotic factors, including cytochrome C and apoptotic-inducing factors, which activate apoptosis.
Definition (NCI_NCI-GLOSS) A drug used to treat certain types of acute lymphoblastic leukemia in children. It is also being studied in the treatment of other types of cancer. Clolar is a type of nucleoside analog.
Definition (PDQ) A second generation purine nucleoside analog with antineoplastic activity. Clofarabine is phosphorylated intracellularly to the cytotoxic active 5'-triphosphate metabolite, which inhibits the enzymatic activities of ribonucleotide reductase and DNA polymerase, resulting in inhibition of DNA repair and synthesis of DNA and RNA. This nucleoside analog also disrupts mitochondrial function and membrane integrity, resulting in the release of pre-apoptotic factors, including cytochrome C and apoptotic-inducing factor, which activate apoptosis. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=257309&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=257309&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C26638" NCI Thesaurus)
Concepts Pharmacologic Substance (T121) , Nucleic Acid, Nucleoside, or Nucleotide (T114)
MSH C068329
SnomedCT 413873006, 417601005
English Cl-F-ara-A, 2-chloro-2'-arabino-fluoro-2'-deoxyadenosine, 2-chloro-2'-fluoroarabino-2'-deoxyadenosine, 2-chloro-9-(2-deoxy-2-fluoro-beta-D-arbinofuranosyl)adenine, 2-Chloro-9-(2-deoxy-2-fluoro-beta-D-arabinofuranosyl)-9H-purin-6-amine, 2-Chloro-9-(2-deoxy-2-fluoroarabinofuranosyl)adenine, clofarabine (medication), CLOFARABINE, clofarabine [Chemical/Ingredient], CAFdA, 2-chloro-9-(2-deoxy-2-fluoroarabinofuranosyl)adenine, clofarabine, Clofarabine, Clofarabine (substance), Clofarabine (product)
Spanish clofarabina (sustancia), clofarabina, clofarabina (producto)