How it is administered

Cladribine is available as an intravenous (IV) infusion and as oral tablets (for other indications). For blood cancers like Hairy Cell Leukemia, it is typically given as a continuous IV infusion. The recommended dose for active Hairy Cell Leukemia is 0.09 mg/kg/day, administered by continuous infusion over 24 hours for 7 consecutive days. The medication must be diluted in a specific solution before administration, and the infusion is usually done in a hospital or clinic setting under the supervision of a healthcare provider.

How it works

Cladribine is a type of chemotherapy known as a purine nucleoside analog. It works by interfering with the growth and activity of certain white blood cells, particularly lymphocytes and monocytes, which are often involved in blood cancers. Once inside the cell, cladribine is converted into an active form that accumulates and disrupts the cell’s ability to repair its DNA. This leads to cell death, especially in cells that are dividing or have a high rate of DNA synthesis.

Because cladribine targets both actively dividing and resting lymphocytes, it is effective in treating cancers like Hairy Cell Leukemia, where abnormal lymphocytes build up in the bone marrow and blood. By reducing these abnormal cells, cladribine helps restore normal blood cell production and improve symptoms related to the disease.

Who Should take it

Cladribine is indicated for adults with active Hairy Cell Leukemia, especially when the disease causes significant symptoms or low blood counts such as anemia, neutropenia, or thrombocytopenia. It may also be considered for other blood cancers in certain situations, but its primary FDA-approved use is for Hairy Cell Leukemia.

Patients who have not responded to other treatments or who have relapsed may also benefit from cladribine. The decision to use cladribine should be made by a healthcare provider experienced in treating blood cancers, taking into account the patient’s overall health and specific disease characteristics.

Who should not take it

Cladribine should not be used by patients who are allergic to cladribine or any of its components. It is also not recommended for patients with active infections, as it can further suppress the immune system and increase the risk of serious or even fatal infections.

Pregnant women should not take cladribine, as it can cause harm to the unborn baby. Women of childbearing potential should use effective contraception during treatment. Caution is advised in patients with significant kidney or liver impairment, as the safety of cladribine in these populations has not been fully established.

Commonly used with

Cladribine is often used as a single agent for Hairy Cell Leukemia. In some cases, it may be used in combination with other supportive treatments, such as antibiotics to prevent or treat infections, or transfusions for low blood counts.

It is not typically combined with other chemotherapy drugs for Hairy Cell Leukemia, but in research or special cases, it may be used alongside other agents for different blood cancers.

Commonly tested with

In clinical studies, cladribine has been tested both as a single agent and in combination with other treatments, such as interferon, cyclophosphamide, or total body irradiation (especially in bone marrow transplant settings). However, for Hairy Cell Leukemia, it is most commonly studied and used alone.

When used in research for other blood cancers, it may be tested with other chemotherapy drugs or immunotherapies, but this is less common in routine practice for Hairy Cell Leukemia.