Drug reference
T-cell acute lymphoblastic leukaemia and T-cell lymphoblastic lymphoma in patients who have relapsed or who are refractory after receiving at least two previous regimens ▶BY INTRAVENOUS INFUSION ▶Adult: (consult local protocol)
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Previous or concurrent craniospinal irradiation (increased risk of neurotoxicity). previous or concurrent intrathecal chemotherapy (increased risk of neurotoxicity)
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Scottish Medicines Consortium (SMC) decisions The Scottish Medicines Consortium has advised (April 2008) that the use of nelarabine (Atriance ®) within NHS Scotland is restricted to bridging treatment before stem cell transplantation and restricted to use by haemato-oncology specialists.
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→Appendix 1: nelarabine
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▶Common or very common Abdominal pain. anaemia. appetite decreased. arthralgia. asthenia. confusion. constipation. cough. diarrhoea. dizziness. drowsiness. dyspnoea. electrolyte imbalance. fever. gait abnormal. headache. hyperbilirubinaemia. hypotension. increased risk of infection. leucopenia. memory loss. movement disorders. muscle weakness. myalgia. nausea. neutropenia. oedema. pain. peripheral neuropathy. respiratory disorders. seizures. sensation abnormal. sepsis. stomatitis. taste altered. thrombocytopenia. tremor. tumour lysis syndrome. vision blurred. vomiting ▶Rare or very rare Rhabdomyolysis ▶Frequency not known Progressive multifocal leukoencephalopathy (PML) SIDE-EFFECTS, FURTHER INFORMATION If neurotoxicity occurs, treatment should be discontinued.
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Manufacturer advises effective contraception during and for at least 3 months after treatment in men and women.
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Avoid (toxicity in animal studies). See also Pregnancy and reproductive function in Cytotoxic drugs p. 938.
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Discontinue breast-feeding.
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▶Neurotoxicity Close monitoring for neurological events is strongly recommended—discontinue if neurotoxicty occurs.
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There can be variation in the licensing of different medicines containing the same drug. Solution for infusion ELECTROLYTES: May contain Sodium ▶Atriance (Novartis Pharmaceuticals UK Ltd) A Nelarabine 5 mg per 1 ml Atriance 250mg/50ml solution for infusion vials | 6 vial P £1,332.00
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Driving and skilled tasks Drowsiness may affect performance of skilled tasks (e.g. cycling or driving).
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(consult local protocol)
First-line fragment. Read the complete Indications and Dose section above.
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