Adult Dosing
Active hairy cell leukemia (HCL)
- 0.09 mg/kg/day by continuous IV infusion X 7 days
Reconstitution
- Add the calculated dose (0.09 mg/kg) of cladribine to 500 mL of 0.9% NaCL and then infuse continuously over 24 hours. Do not use 5% dextrose for dilution due to risk of increased degradation. Repeat this procedure for 7 days
Chronic lymphocytic leukemia (CLL) (FDA unapproved)
- 0.12 mg/kg/day IV on days 1 through 5 of a 28 day cycle
- Max 6 cycles in responding patients; discontinue treatment if no response after 2 cycles
Reconstitution
- Add the calculated dose (0.12 mg/kg ) of cladribine to an infusion bag containing 100 mL to 500 mL of 0.9% NaCL. Infuse continuously over 2 hours. Do not use 5% dextrose for dilution due to risk of increased degradation. Repeat this procedure for 5 consecutive days
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
- Delay or discontinue if neurotoxicity or renal toxicity occurs
- Avoid use of benzyl alcohol in neonates; fatal "Gasping Syndrome" may occur
- Pyrexia is commonly observed during the first month of therapy and frequently requires antibiotic therapy
- Tumor lysis syndrome and subsequent hyperuricemia may occur with high tumor burden
- Monitor hematological profile periodically during treatment and 4-8 wks after each course, to determine the degree of hematopoietic suppression
- Monitor hepatic and renal function during treatment
- Do not administer live attenuated vaccines to patients receiving cladribine injection. Severe bone marrow suppression, including neutropenia, anemia and thrombocytopenia, has been reported in patients treated with high doses of cladribine
Cautions: Use cautiously in
- Hepatic impairment
- Renal impairment
- Geriatric population
- Preexisting haematologic
- Myelosuppression
- Active infection
Pregnancy Category:D
Breastfeeding: Safety unknown. Use not recommended due to potential to cause severe adverse events in the neonate
