Indications
- Acute Myeloid Leukemia (AML) (see Acute Myeloid Leukemia, [[Acute Myeloid Leukemia]]): as part of FLAG regimen (fludarabine + cytarabine + G-CSF)
- Chronic Lymphocytic Leukemia (CLL) (see Chronic Lymphocytic Leukemia, [[Chronic Lymphocytic Leukemia]]): higher response rates than alkylating agents or chlorambucil alone
- Conditioning for Bone Marrow Transplant (BMT)/Stem Cell Transplant (SCT) (see Bone Marrow Transplant, [[Bone Marrow Transplant]]): due to its immunosuppressive effects
- Non-Hodgkin’s Lymphoma (see Lymphoma, [[Lymphoma]]): indicated for indolent lymphomas
Pharmacology
- Nucleoside (Purine) Analogue
Administration
Dose Adjustments
Adverse Effects
Pulmonary Adverse Effects
Diffuse Alveolar Hemorrhage (DAH) (see Diffuse Alveolar Hemorrhage, [[Diffuse Alveolar Hemorrhage]])
- Pathology: absence of pulmonary capillaritis (bland alveolar hemorrhage)
Drug-Induced Pulmonary Eosinophilia (see Drug-Induced Pulmonary Eosinophilia, [[Drug-Induced Pulmonary Eosinophilia]])
- Epidemiology: case reports
Pneumocystis Jirovecii Infection (see Pneumocystis Jirovecii, [[Pneumocystis Jirovecii]])
- Increased Risk When Used in Intensive Treatment Regimen for Autologous Bone Marrow Transplant (BMT)/Stem Cell Transplant (SCT) (see Bone Marrow Transplant, [[Bone Marrow Transplant]])
- Increased Risk When Used in Combination with Cyclophosphamide (Cytoxan) (see Cyclophosphamide, [[Cyclophosphamide]])
- Epidemiology: occurs in 8.6% of cases
- Diagnosis
- CXR/Chest CT: alveolar infiltrates, mixed alveolar-interstitial infiltrates, or nodular infiltrates
- Treatment: withdraw drug + corticosteroids
Other Adverse Effects
References
- Eosinophilic pneumonia after administration of fludarabine for the treatment of non-Hodgkin’s lymphoma. Ann Hematol. 2002 Sep;81(9):535-7 [MEDLINE]