Acute lymphoblastic leukemia ALL

Most common adverse effects are-

GI tract symptoms , including vomiting, nausea, and diarrhea
Haematologic effects, including anemia, leukopenia, thrombocytopenia, neutropenia, annd fabrile neutropenia

Cardiovascular -
Flushing  15%  hypertension 10% tachycardia 30%

CNS -
 Anxiety  20%  depression  10%  dizziness 13%   headache  40% irritabilty 10%

Dermatologic -
Confusion  10%     dermatitis  35%  dry skin 8%  erythema  15%  petechiae   25%  pruritus 40%

GI  
Abdominal pain  30%  constipation 18%   diarrhea   45%  nausea  65%  vomiting  75%

GU
Hematuria  14%  febrile neutropenia 50% 

Hepatic -
Hepatomegaly    12%  jaundice 12% 

Metabolic /nutrition
Anorexia  25%   edema 15% 

Musculoskeletal
Arthalgia   10%   back pain 10%   myalgia 10%  pain in limb  25%

Respiratory
Cough   15%    epistaxis  25%   respiratory distress 11%

Miscellaneous
 Fatigue  30%  injection site pain  12%  pyrexia 35%  rigors 35%        

Special Precautions/Warnings-

Administeration- administer clofarabine under the supervision of qualifed physician

Bone marrow depression- anticipate suppression of bone marrow function. appears to be
reversible and dose dependent

Tumor lysis syndrome and other adverse reactions- administration of clofarabine results in rapid reduction of peripheal leukemia cells. Evaluate patients undergoing treatment with clofarabine and monitor for signs and symptoms of tumor lysis syndrome.

Renal hepatic function impairment - use caution when administering to  this population  

Pregnancy - clofarabine may cause fetal harm when administered to pregnant woman. Excercise  caution 

Lactation- Women treated with clofarabine should not breast feed

Children-  safety and efficacy has not been established

Monitoring- obtain complete blood counts and platelet counts t regular intervals during
clofarabine therapy

Indication

Acute lymphoblastic leukemia  (ALL )

Dosage-
Recommended dose 52mg/m2 administered by intravenous infusion over a period over 2 hours daily for 5 consecutive days. Treatment cycles are repeated following recovery or return to baseline organ function, aprox every 2 to 6 weeks.

1. Patients receving clofarabine may expereience vomiting and and diarrhea. Advice the patients  to report to their doctor to avoid dehydration.

2. Patients may experience symptoms of lightheadeness ,fainting,spells or decreased urine out put. Patients may develop hypotension during the period of treatment, consult your doctor.

3. Closely monitor patients taking medicines known to affect blood pressure  or cardiac function  during administration of clofarabine .

4. Advice patients to use effective contraceptive measures to prevent pregnancy.

Pregnancy -
Clofarabine may cause fetal harm when administered to pregnant woman. Excercise
caution 

Lactation-
 Women treated with clofarabine should not breast feed

Children- 
Safety and efficacy has not been established