Nelarabine in the Treatment of Refractory T-Cell Malignancies

Author:

Roecker Andrew M.1,Stockert Amy2,Kisor David F.2

Affiliation:

1. Raabe College of Pharmacy, Department of Pharmacy Practice, Ohio Northern University, Ada, Ohio, USA.

2. Raabe College of Pharmacy, Department of Pharmaceutical and Biomedical Sciences, Ohio Northern University, Ada, Ohio, USA.

Abstract

Nelarabine is a nucleoside analog indicated for the treatment of adult and pediatric patients with T-cell acute lymphoblastic leukemia (T-ALL) or T-cell lymphoblastic lymphoma (T-LBL) that is refractory or has relapsed after treatment with at least two chemotherapy regimens. After being first synthesized in the late 1970s and receiving FDA approval in 2005, the appropriate use of nelarabine for refractory hematologic malignancies is still being elucidated. Nelarabine is the prodrug of 9-β-D-arabinofuranosylguanine (ara-G) which when phosphorylated intracellularly to ara-G triphosphate (ara-GTP), preferentially accumulates in cancerous T-cells. Dose-dependent toxicities, including neurotoxicity and myelosuppression, have been documented and may, in turn, limit the ability to appropriately treat the diagnosed malignancy. This article will summarize the pharmacologic properties of nelarabine and will address the current place in therapy nelarabine holds based upon the results of the available clinical trials to date.

Publisher

SAGE Publications

Subject

Oncology

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