Fludarabine

Fludarabine

drugbox
IUPAC_name = [(2"R",3"R",4"S",5"R")-5-(6-amino-2-fluoro-purin-9-yl)- 3,4-dihydroxy-oxolan-2-yl] methoxyphosphonic acid



CAS_number = 75607-67-9
ATC_prefix = L01
ATC_suffix = BB05
ATC_supplemental =
PubChem = 30751
DrugBank = APRD00594
C = 10 | H = 13 | F = 1 | N = 5 | O = 7 | P = 1
molecular_weight = 365.212 g/mol
bioavailability = 55%
protein_bound = 19 to 29%
metabolism =
elimination_half-life = 20 hours
excretion = Renal
pregnancy_category = D
legal_AU= S4
legal_UK = POM
legal_US =
legal_status =
routes_of_administration = Intravenous, oral

Fludarabine (marketed as fludarabine phosphate under the trade name Fludara) is a chemotherapy drug used in the treatment of hematological malignancies.

Indications

Fludarabine is highly effective in the treatment of chronic lymphocytic leukemia, producing higher response rates than alkylating agents such as chlorambucil alone.Rai KR et al. Fludarabine compared with chlorambucil as primary therapy for chronic lymphocytic leukemia. N Engl J Med 2000;343:1750-7. PMID 11114313] Fludarabine is used in various combinations with cyclophosphamide, mitoxantrone, dexamethasone and rituximab in the treatment of indolent non-Hodgkins lymphomas. As part of the "FLAG" regimen, fludarabine is used together with cytarabine and granulocyte colony-stimulating factor in the treatment of acute myeloid leukaemia. Because of its immunosuppressive effects, fludarabine is also used in some conditioning regimens prior to non myeloablative allogeneic stem cell transplant.

Pharmacology

Fludarabine is a purine analog, and can be given both orally and intravenously. Fludarabine inhibits DNA synthesis by interfering with ribonucleotide reductase and DNA polymerase. It is active against both dividing and resting cells.

ide effects

Fludarabine is associated with profound lymphopenia, and as a consequence, increases the risk of opportunistic infections significantly. Patients who have been treated with fludarabine will usually be asked to take co-trimoxazole or to use monthly nebulised pentamidine to prevent "Pneumocystis jiroveci" pneumonia. The profound lymphopenia caused by fludarabine renders patients susceptible to transfusion-associated graft versus host disease, a fatal complication of blood transfusion. For this reason, all patients who have ever received fludarabine should only be given irradiated blood components.

Fludarabine causes anemia, thrombocytopenia and neutropenia, requiring regular blood count monitoring. Some patients require blood and platelet transfusion, or G-CSF injections to boost neutrophil counts.

Fludarabine is associated with the development of severe autoimmune hemolytic anemia in a proportion of patients.Gonzalez H et al. Severe autoimmune hemolytic anemia in eight patients treated with fludarabine. Hematol Cell Ther. 1998;40:113-8. PMID 9698219]

Difficulties are often encountered when harvesting peripheral blood stem cells from patients previously treated with fludarabine.Tournilhac O et al. Impact of frontline fludarabine and cyclophosphamide combined treatment on peripheral blood stem cell mobilization in B-cell chronic lymphocytic leukemia. Blood 2004;103:363-5. PMID 12969985]

References

External links

* [http://www.fludara.com/ Fludara webpage]


Wikimedia Foundation. 2010.

Игры ⚽ Поможем сделать НИР

Look at other dictionaries:

  • Fludarabine — Général No CAS …   Wikipédia en Français

  • fludarabine — noun A particular drug used in chemotherapy …   Wiktionary

  • fludarabine — flu·dar·a·bine flü dar ə .bēn n an antineoplastic agent that is an analog of vidarabine and is administered intravenously in the form of its phosphate C10H13FN5O7P esp. in the treatment of chronic lymphocytic leukemia …   Medical dictionary

  • fludarabine — An anticancer drug that is a type of antimetabolite …   English dictionary of cancer terms

  • fludarabine phosphate — flu·dar·a·bine phos·phate (floo darґə bēn) an adenine analogue and purine antimetabolite that inhibits DNA synthesis, used as an antineoplastic in the treatment of chronic lymphocytic leukemia; administered intravenously …   Medical dictionary

  • FAMP — fludarabine …   Medical dictionary

  • FAMP — • fludarabine …   Dictionary of medical acronyms & abbreviations

  • 75607-67-9 — Fludarabine Fludarabine Général No CAS …   Wikipédia en Français

  • C10H13FN5O7P — Fludarabine Fludarabine Général No CAS …   Wikipédia en Français

  • Chronic lymphocytic leukemia — Infobox Disease Name = Chronic lymphocytic leukemia Caption = Peripheral blood smear showing CLL cells DiseasesDB = 2641 ICD10 = ICD10|C|91|1|c|81 ICD9 = ICD9|204.9 ICDO = 9823/3 | OMIM = MedlinePlus = 000532 eMedicineSubj = med eMedicineTopic =… …   Wikipedia

Share the article and excerpts

Direct link
Do a right-click on the link above
and select “Copy Link”