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How it is administered
Cladribine is given as an intravenous (IV) infusion. The standard treatment for active Hairy Cell Leukemia is a single course of continuous infusion over 7 consecutive days at a dose of 0.09 mg/kg/day. The medication must be diluted with 0.9% Sodium Chloride Injection before administration. It is important that cladribine is prepared and administered by healthcare professionals experienced in chemotherapy.
The infusion is typically administered in a hospital or specialized clinic setting to ensure proper monitoring and management of any side effects.
How it works
Cladribine is a synthetic chemotherapy drug that targets certain types of white blood cells, including those involved in Hairy Cell Leukemia. It works by mimicking a natural building block of DNA, which allows it to enter the cancerous cells. Once inside, cladribine is converted into an active form that interferes with the cell's ability to repair and replicate its DNA. This leads to the accumulation of toxic substances within the cell, ultimately causing the cell to die.
Cladribine is unique because it can kill both actively dividing and resting (non-dividing) cancer cells. This makes it especially effective for diseases like Hairy Cell Leukemia, where cancer cells may not always be rapidly dividing. By disrupting DNA synthesis and repair, cladribine helps reduce the number of abnormal cells in the blood and bone marrow, allowing normal blood cell production to recover.
Common side effects
Common side effects of cladribine include:
- Fatigue (31%)
- Fever (33%)
- Nausea (22%)
- Rash (16%)
- Headache (14%)
- Vomiting (9%)
- Decreased appetite (8%)
- Febrile neutropenia (8%)
- Cough (7%)
- Diarrhea (7%)
- Myalgia (muscle pain, 6%)
- Dizziness (6%)
- Pain (6%)
- Asthenia (weakness, 6%)
Other possible side effects include infections, anemia, thrombocytopenia (low platelets), and administration site reactions. Most side effects are mild to moderate, but serious infections can occur, especially in the first month after treatment.
Who Should take it
Cladribine is specifically indicated for adults with active Hairy Cell Leukemia. This means it is used when the disease is causing significant problems, such as low red blood cell counts (anemia), low white blood cell counts (neutropenia), low platelet counts (thrombocytopenia), or other symptoms related to the leukemia.
It can be used as a first-line treatment for patients who have not received prior chemotherapy, as well as for those who have been treated before with other therapies. Cladribine has been shown to be effective in both newly diagnosed and previously treated patients, although response rates may be lower in those who have received certain prior treatments.
Who should not take it
Cladribine should not be used in patients who are allergic or hypersensitive to cladribine or any of its components. It is also not recommended for use in pregnant women, as it can cause harm to the unborn baby (Pregnancy Category D). Women of childbearing potential should use effective contraception during treatment.
Caution is advised in patients with known or suspected kidney or liver problems, as the safety of cladribine in these groups has not been fully established. It is also not recommended for use in children, as safety and effectiveness in pediatric patients have not been established. Patients should not receive live vaccines while being treated with cladribine due to the risk of infection.
Commonly used with
Cladribine is generally used alone as a single-agent chemotherapy for Hairy Cell Leukemia. It is not typically combined with other chemotherapy drugs during the initial treatment course.
However, supportive medications such as antibiotics, antifungals, or antivirals may be used to prevent or treat infections, especially if the patient develops neutropenia (low white blood cells). Blood transfusions may also be needed if anemia or low platelets occur.
Commonly tested with
In clinical studies for Hairy Cell Leukemia, cladribine has been tested as a single agent. Some studies have included patients who previously received other treatments, such as interferon or deoxycoformycin, but cladribine itself is not routinely tested in combination with other chemotherapy agents for this disease.
Patients in clinical trials may receive supportive care medications to manage side effects or complications, but the focus of testing is typically on cladribine alone for Hairy Cell Leukemia.
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