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Nelarabine

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Abstract

  • ▴ Nelarabine is an anticancer prodrug of arabinofura-nosylguanine (ara-G), which is metabolized in cells to the cytotoxic metabolite ara-G triphosphate (ara-GTP).

  • ▴ Ara-GTP competes with deoxyguanosine triphosphate for incorporation into DNA. Once incorporated, it inhibits DNA synthesis and leads to high molecular weight DNA fragmentation and cell death.

  • ▴ In paediatric and adult patients with T-cell acute lymphoblastic leukaemia or T-cell lymphoblastic lymphoma, nelarabine induced a complete response, with or without complete haematological recovery, in approximately one-fifth of patients who had not responded to, or had relapsed following treatment with, two or more prior chemotherapy regimens.

  • ▴ The median overall survival time was 13.1 and 20.6 weeks in paediatric and adult patients, with corresponding 1-year survival rates of 14% and 29%.

  • ▴ Treatment-emergent adverse events were common, but non-haematological events were mostly of mild or moderate severity.

  • ▴ Neurological events, which may be severe and irreversible, were the most likely adverse events to limit treatment.

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Authors and Affiliations

  1. Wolters Kluwer Health ¦ Adis, 41 Centorian Drive, Private Bag 65901, Mairangi Bay, North Shore, Auckland, 0754, New Zealand

    Mark Sanford & Katherine A. Lyseng-Williamson

  2. Wolters Kluwer Health, Conshohocken, Pennsylvania, USA

    Mark Sanford & Katherine A. Lyseng-Williamson

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  1. Mark Sanford
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  2. Katherine A. Lyseng-Williamson
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Correspondence to Mark Sanford.

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Sanford, M., Lyseng-Williamson, K.A. Nelarabine. Drugs 68, 439–447 (2008). https://doi.org/10.2165/00003495-200868040-00004

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