Classifications: antineoplastic; purine antimetabolite; Therapeutic: antineoplastic; antimetabolite
Pregnancy Category: D
1 mg/mL injection.
Clofarabine inhibits DNA repair within cancer cells, thus interfering with mitosis; it also disrupts the mitochondrial membrane,
leading to cancer cell death.
Cytotoxic to rapidly proliferating and quiescent cancer cells.
Treatment of persons 121 y of age with relapsed or refractory acute lymphocytic leukemia (ALL) after at least 2 prior
Severe bone marrow suppression; active infection; pregnancy (category D); lactation.
Renal or hepatic function impairment; thrombocytopenia; neutropenia; previous chemotherapy or radiation therapy; females
of childbearing age; history of viral infections such as herpes; history of cardiac disease or hypotension.
Route & Dosage
|Acute Lymphocytic Leukemia
Adult/Adolescent/Child: IV 52 mg/m2/d for 5 d
PREPARE: IV Infusion: Withdraw required dose from vial using a 0.2 micron filter syringe. Further dilute with D5W or NS prior to infusion.
ADMINISTER: IV Infusion: Give over 2 h. Note: It is recommended that IV fluids be given continuously throughout the 5 d of clofarabine administration.
- Store diluted solution at room temperature. Use within 24 h of mixing.
Adverse Effects (≥1%) CNS:
, dizziness, headache, irritability, somnolence. CV: Tachycardia,
pericardial infusion, left ventricular systolic dysfunction (LSVT). GI: Vomiting, nausea,
abdominal pain, constipation
. Hematologic/Lymphatic: Anemia, leukopenia, thrombocytopenia, neutropenia, febrile neutropenia. Hepatic: Jaundice
, hepatomegaly. Metabolic:
Anorexia, decreased appetite, edema, decreased weight. Musculoskeletal: Arthralgia
, back pain, myalgia. Respiratory:
, epistaxis, pleural effusion, respiratory distress. Skin:
Dermatitis, contusion, dry skin, erythema
, palmar-plantar erythrodysesthesia syndrome
, pruritus. Body as a Whole:
Increase risk of infection
47% protein bound. Metabolism:
Primarily unchanged in the urine. Half-Life:
Assessment & Drug Effects
- Monitor vital signs frequently during infusion of clofarabine.
- Monitor closely for S&S of capillary leak syndrome or systemic inflammatory response syndrome (e.g., tachypnea, tachycardia,
hypotension, pulmonary edema). If either is suspected, immediately DC IV, institute supportive measures and notify physician.
- Monitor I&O rates and pattern and watch for S&S of dehydration, including dizziness, lightheadedness, fainting spells, or
decreased urine output.
- Withhold drug and notify physician if hypotension develops for any reason during 5-d period of drug administration.
- Lab tests: Baseline and periodic CBC and platelet counts (more frequent with cytopenias); frequent LFTs and kidney function
test during the 5 d of clofarabine therapy.
Patient & Family Education
- Report any distressing adverse effect of therapy to physician.
- Use effective measures to avoid pregnancy while taking this drug.