II. Indications
- FDA Approved
- Acute Lymphoblastic Leukemia (refractory, age <=21 years)
- Off-Label Use
- Acute Lymphocytic Leukemia (refractory)
- Acute Myelogenous Leukemia (refractory)
- Langerhans Cell Histiocytosis (children)
III. Mechanism
- Antineoplastic Agent for Antimetabolite Chemotherapy
- Second generation purine Nucleoside analog
- Clofarabine triphosphate (an active metabolite) incorporates into DNA
- Results in inhibition of synthesis and repair of DNA
- Also disrupts mitochondrial function
IV. Medications
- IV Solution: 20 mg in 20 ml
V. Dosing
- See other references for disease specific dosing protocols
- Reduce dosing in moderate renal Impairment
VI. Adverse Effects
- Acute Kidney Injury
- Hepatitis or hepatic failure
- Myelodepression
- Myelodysplastic Syndrome
- Tumor Lysis Syndrome
VII. Safety
- Avoid in Pregnancy (any trimester)
- Use reliable Contraception
- Avoid in Lactation
- Monitoring