Info

Agent

Mechanism of action Clinical uses

Common toxicities

Purine analogs Fludarabine, Fludara

CLL, NHL

Purine analogs Fludarabine, Fludara

Adenosine analog; incorporated into DNA resulting in chain termination; also inhibits ribonucleotide reductase, which depletes cells of deoxyribonucleotide triphosphate pools

CLL, NHL

■ DLT0 = Myelo-suppression (onset 10-14 days21)

■ Neurotoxicity

■ Immunosuppression (can last up to 2 years22)

■ Mild nausea/vomiting

■ Interstitial pneumonitis (onset ranges from 3 days after first cycle to 6 days after seventh cycle23)

Cladribine, 2-CDA, Leustatin

Adeosine analog; incorpo rated into DNA resulting in chain termination; also inhibits ribonucleotide reductase, which depletes cells of deoxyribonucleotide triphosphate pools

Hairy cell leukemia, NHL

■ DLT = Myelo-suppression (onset 7-14 days24)

■ Immunosuppression (onset 4-6 months; typically lasts 1 year, may last up to 40 months24)

-Mercaptopurine, -MP

Hypoxanthine analog; interferes with purine biosynthesis; also incorporated into DNA resulting in chain termination25

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