Nelarabine (Arranon)
Also known as Atriance.
General information
Class/mechanism: Purine analog, antimetabolite. Nelarabine is metabolized to the cytotoxic deoxyguanosine analogue, 9-β-Darabinofuranosylguanine (ara-G), which is eventually converted to ara-GTP. ara-GTP is incorporated into DNA and leads to inhibition of DNA synthesis and cell death.[1][2]
Route: IV
Extravasation: no information
For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias such as Micromedex, Lexicomp, UpToDate (courtesy of Lexicomp), or the prescribing information.[1]
Diseases for which it is used
T-cell acute lymphoblastic leukemia and T-cell lymphoblastic lymphoma
Patient drug information
- Nelarabine (Arranon) package insert PDF pages 17-19[1]
- Nelarabine (Arranon) patient drug information (Chemocare)[3]
- Nelarabine (Arranon) patient drug information (UpToDate)[4]
History of changes in FDA indication
- 10/28/2005: Initial FDA approval "for the treatment of patients with T-cell acute lymphoblastic leukemia and T-cell lymphoblastic lymphoma whose disease has not responded to or has relapsed following treatment with at least two chemotherapy regimens."