II. Indications
- Chronic Lymphocytic Leukemia (CLL, FDA approved)
- Non-Hodgkin's Lymphoma
- Acute Myelogenous Leukemia (AML)
- Hematopoietic Stem Cell Transplant conditioning
III. Mechanism
- Nucleotide antimetabolite with antineoplastic activity
- Fludarabine is a fluorinated analog of vidarabine (ara-A), an Antiviral Agent
- Fludarabine is a prodrug, infused as a phosphate salt (Fludarabine phosphate)
- Dephosphorylated to 2-fluoro-ara-A (rapidly on intravenous infusion)
- Intracellularly phosphorylated to the active triphosphate, 2-fluoro-ara-ATP (via deoxycytidine kinase)
- 2-fluoro-ara-ATP inhibits DNA Polymerase, ribonucleotide reductase and DNA primase
- Inhibits tumor cell growth
IV. Medications
- Fludarabine IV Solution in 50 mg vials
V. Adverse Effects
- Myelosuppression
- Progressive Multifocal Leukoencephalopathy
- Lung Toxicity
- Hyperuricemia
- Impaired future fertility
- Alopecia
- Neurotoxicity
- Blindness
- Altered Level of Consciousness (Agitation to coma)
- Autoimmune
- Hemolytic Anemia
- Thrombocytopenia (including Immune Thrombocytopenic Purpura)
- Acquired Hemophilia
- Combined cytopenia (Evan's Syndrome)
VI. Safety
- Avoid in Lactation
- Avoid in pregnancy (all trimesters)
- Use reliable Contraception
- Monitoring
VII. Resources
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Related Studies
Definition (NCI) | A fluorinated nucleotide antimetabolite analog of the antiviral agent vidarabine (ara-A) with antineoplastic activity. Administered parenterally as a phosphate salt, fludarabine phosphate is rapidly dephosphorylated to 2-fluoro-ara-A and then phosphorylated intracellularly by deoxycytidine kinase to the active triphosphate, 2-fluoro-ara-ATP. This metabolite may inhibit DNA polymerase alpha, ribonucleotide reductase and DNA primase, thereby interrupting DNA synthesis and inhibiting tumor cell growth. (NCI04) |
Definition (NCI_NCI-GLOSS) | The active ingredient in a drug used to treat B-cell chronic lymphocytic leukemia (CLL) that has not responded to treatment with other anticancer drugs or that has gotten worse. Fludarabine blocks cells from making DNA and may kill cancer cells. It is a type of purine antagonist and a type of ribonucleotide reductase inhibitor. |
Definition (CSP) | nucleoside analog used alone or in combination with other agents to treat various cancers, especially leukemia. |
Concepts | Pharmacologic Substance (T121) , Nucleic Acid, Nucleoside, or Nucleotide (T114) |
MSH | C024352 |
SnomedCT | 108763009, 386907005 |
English | 2-fluoroadenine arabinoside, 9H-purin-6-amine, 9-beta-D-arabinofuranosyl-2-fluoro-, F-ara-A, 2-Fluoro-9-beta-arabinofuranosyladenine, 2-Fluorovidarabine, 9-Beta-D-arabinofuranosyl-2-fluoro-9H-purin-6-amine, 9-Beta-D-arabinofuranosyl-2-fluoroadenine, F Ara A, fludarabine [Chemical/Ingredient], FLUDARABINE, Fludarabine, Fludarabine (product), Fludarabine (substance), FAMP, 9-beta-D-arabinofuranosyl-2-fluoroadenine, fludarabine |
Spanish | fludarabina (producto), fludarabina (sustancia), fludarabina |