Adult Dosing
- Safety and effectiveness in adults (>21 yrs of age) have not been established
ALL, refractory or relapsed
12-21 yrs
- 52 mg/m2 IV qd x 5 days
- Repeat q2-6 wks
- Continue hydration and prophylactic steroids & allopurinol
- Alkalinize urine throughout the 5 days of administration
- Closely monitor hepatic and renal function; if substantial increases in creatinine or bilirubin are noted, discontinue administration
- Discontinue if hypotension occurs during the 5 days of administration
Pediatric Dosing
ALL, refractory or relapsed
< 12 yrs
- 52 mg/m2 IV qd x 5 days
- Repeat q2-6 wks
- Continue hydration and prophylactic steroids & allopurinol
- Alkalinize urine throughout the 5 days of administration
- Closely monitor hepatic and renal function; if substantial increases in creatinine or bilirubin are noted, discontinue administration
- Discontinue if hypotension occurs during the 5 days of administration
- Administer under the supervision of a physician experienced in use of antineoplastic therapy
- Administer as an IV infusion for over 2 hrs for 5 consecutive days
- Reversible bone marrow suppression including neutropenia, anemia, and thrombocytopenia, has occurred. Monitor CBC with differential and platelet count
- Increased risk of infections due to immunosuppression; monitor for signs and symptoms of infection and treat promptly
- May cause fetal harm when administered during pregnancy, advise women of childbearing potential to use effective contraceptive measures to prevent pregnancy
- Monitor BP during the 5 days of clofarabine administration; discontinue if patient develops hypotension
- Monitor BUN/Cr, LFTs at baseline, then periodically thereafter
- Monitor signs and symptoms of tumorlysis syndrome and cytokine release that could develop into systemic inflammatory response syndrome (SIRS), capillary leak, and organ dysfunction. Discontinue immediately.
Cautions: Use cautiously in
- Renal impairment
- Hepatic impairment
- Concurrent use of nephrotoxic drugs
- Concurrent use of hepatotoxic drugs
- Hypotension
- Hematopoeitic stem cell therapy
- Immunocompromised patients
Pregnancy Category:D
Breastfeeding: Unsafe. Due to potential for tumorigenecity shown for clofarabine in animal studies and the potential for serious adverse events, women treated with clofarabine should not breastfeed
