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Cladribine

Adenosine 2 Chloro 2' Deoxy


Presentation

  • The second presentation reported data from the open-label maintenance phase of the ORACLE-MS study ( NCT00725985 ).[multiplesclerosisnewstoday.com]
  • Skin and bone marrow biopsies confirmed a diagnosis of SM, initially presenting with urticaria pigmentosa.[ncbi.nlm.nih.gov]
  • EMD Serono to Present Data Highlighting Investigational Cladribine Tablets at CMSC 2017 - Company to present eight abstracts evaluating the efficacy and safety of Cladribine Tablets for the treatment of relapsing multiple sclerosis - Oral presentation[media.emdserono.com]
  • Splenomegaly was present in 93.5% of cases at diagnosis. The laboratory findings that came into prominence were pancytopenia with grade 3 bone marrow fibrosis.[ncbi.nlm.nih.gov]
  • […] at EAN Congress are consistent with other clinical safety presentations of MAVENCLAD (Cladribine Tablets) at the congress Merck announced the presentation of safety and efficacy data on MAVENCLAD (Cladribine Tablets) for the treatment of relapsing MS[acnr.co.uk]
Intravenous Drugs
  • Solutions containing LEUSTATIN Injection should not be mixed with other intravenous drugs or additives or infused simultaneously via a common intravenous line, since compatibility testing has not been performed.[globalrph.com]
  • Do not mix solutions containing cladribine with other intravenous drugs or additives or infuse simultaneously via a common intravenous line, as compatibility testing has not been performed.[pdr.net]
Intravenous Administration
  • Cladribine plasma concentration after intravenous administration declines multi-exponentially with an average half-life of 6.7 /- 2.5 hours.[globalrph.com]
  • Intravenous Administration CAUTION: Observe and exercise usual cautions for handling and preparing solutions of cytotoxic drugs.[pdr.net]
Turkish
Peripheral Neuropathy
  • Although, severe neurologic toxicity appears to be dose related, rarely severe neurotoxicity, axonal peripheral neuropathy, has been reported following standard dose cladribine therapy.[pdr.net]
  • Cladribine has also been reported to have been used to treat a single patient suffering from IgM associated inflammatory peripheral neuropathy that, unlike MS and NMO, is a non-relapsing, non-remitting disease.[google.com]
  • In contrast, Vahdat and colleagues at the Memorial Sloan-Kettering Cancer Center reported that sensorimotor peripheral neuropathy was dose-limiting non-hematologic toxicity in a dose escalation study in patients with acute myeloid leukemia, excluding[academic.oup.com]
  • neuropathy after completing 2 courses of low-dose cladribine (0.1 mg/kg per day 2-hour infusion for 7 days). 119 In addition, at very elevated doses (more than triple the approved dose), a delayed severe motor weakness developed. 120 Future research[bloodjournal.org]
Dysarthria
  • A 67-year-old male presented with a 3-weeks history of unsteady gait, dysarthria and a dysfunctional right arm. Seven years earlier, he had been diagnosed with urticaria pigmentosa, and 2 years later aggressive systemic mastocytosis.[ncbi.nlm.nih.gov]

Treatment

  • […] as the most efficient licensed treatments.[ncbi.nlm.nih.gov]
  • Cladribine was used as the first-line treatment in 9 patients and as later-line treatment in the remaining 12 patients. The median number of cycles of cladribine administered was 2.5 (range, 1-6).[ncbi.nlm.nih.gov]
  • Most of the patients with an indication for treatment were treated with cladribine as first-line treatment. Total and complete response of cladribine was 97.3% and 80.7%.[ncbi.nlm.nih.gov]
  • (MS) and switch to treatment with a different disease-modifying drug (ie, subcutaneous interferon beta-1a), according to data presented at the 32nd Congress of the European Committee for Treatment and Research in MS (ECTRIMS).[mdedge.com]
  • Treatment for other conditions Always tell other doctors, nurses, pharmacists or dentists that you’re having this treatment if you need treatment for anything else, including teeth problems.[cancerresearchuk.org]

Prognosis

  • Histiocytic sarcoma, a rare hematopoietic neoplasm with evidence of histiocytic differentiation, is often refractory to conventional chemotherapy and radiotherapy, and its prognosis is generally dismal.[ncbi.nlm.nih.gov]
  • The prognosis for relapsing AML patients is disappointing and the preferred salvage chemotherapy is unclear. Among other regimens, cladribine, cytarabine, and idarubicin (CLA-Ida) is used.[ncbi.nlm.nih.gov]
  • Mantle cell lymphoma (MCL) is an aggressive type of B-cell non-Hodgkin lymphoma associated with poor prognosis.[ncbi.nlm.nih.gov]
  • The aim was to improve prognosis especially in FAB M4/M5/MLL patients, who represent the largest subgroup of HR patients.[cancerindex.org]
  • Therefore, 2-CdA could be effective in the treatment of adult T-cell leukemia-lymphoma (ATL), which is a T-cell malignancy with an extremely poor prognosis.[academic.oup.com]

Etiology

  • […] the rate of neoplasms, both malignant and benign, was similar but numerically slightly higher for the 3.5-mg drug group than the placebo group (1.14 and 1.01), the researchers said, adding that there was "no clustering of malignancies with a common etiology[medpagetoday.com]
  • Respiratory, thoracic and mediastinal disorders: Pulmonary interstitial infiltrates (including lung infiltration, interstitial lung disease, pneumonitis and pulmonary fibrosis ); in most cases, an infectious etiology was identified.[rxlist.com]
  • In view of the known toxicities of agents of this class, it would be prudent to proceed carefully in patients with known or suspected renal insufficiency or severe bone marrow impairment of any etiology.[globalrph.com]

Epidemiology

  • . · Category Pharmacology Cladribine is a small molecule that may interfere with the behaviour and the proliferation of certain white blood cells, particularly lymphocytes, thought to be involved in the pathological process of MS Epidemiology NICE estimate[sps.nhs.uk]
  • […] combination did report a statistical increase in lung cancer incidence among cladribine-based therapy, but the authors made no definitive conclusions. 110 A comparison of purine analog-treated patients to an age-adjusted population from the Surveillance, Epidemiology[bloodjournal.org]
  • We presented three very different cases of HCL in very old patients diagnosed in a single center and discussed some epidemiological and therapeutical issues in such patients.[cancerindex.org]
Sex distribution
Age distribution

Pathophysiology

  • Immunotherapeutic approaches in MS: update on pathophysiology and emerging agents or strategies 2006. Endocr Metab Immune Disord Drug Targets 2007 ;7: 35 - 63 4. Cohen BA, Rieckmann P. Emerging oral therapies for multiple sclerosis.[nejm.org]

Prevention

  • Wash your hands well to prevent the spread of infections. To lower your risk of getting cut, bruised, or injured, use caution with sharp objects like razors and nail cutters, and avoid activities such as contact sports.[webmd.com]
  • Tips to preventing infection: Washing hands , both yours and your visitors, is the best way to prevent the spread of infection.[oncolink.org]
  • Your doctor will give you anti-sickness drugs to help prevent or control sickness. Take the drugs exactly as your nurse or pharmacist tells you. It is easier to prevent sickness than to treat it after it has started.[macmillan.org.uk]
  • Women who could get pregnant should use effective contraception to prevent pregnancy, and men should use effective contraception to prevent fathering a child, both during treatment, and for at least six months after treatment is finished.[netdoctor.co.uk]

References

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