- T-cell Acute Lymphoblastic Leukemia
- T-cell Lymphoblastic Lymphoma
THIS MEDICATION IS TO BE ADMINISTERED BY A CHEMO-TRAINED NURSE. IF THE NURSE IS NOT CHEMO-TRAINED, THEY ARE TO CONTACT THE UNIT NURSE EDUCATOR OR ADVANCED PRACTICE NURSE.
- Available as a 5 mg/mL (50 mL) solution.
- Store at room temperature. Do not refrigerate vials - crystallization may occur.
- Solution is used full strength directly from the vial or transferred to a glass or PVC container. No further dilution is required.
- Transferred solutions are stable 8 hours at room temperature.
- Solutions Compatible: 0.9% NaCl
- Additives/Above Cassette Compatible: no information
- Y-site Compatible: no information
- Incompatible: no information
(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)
| SC | NO |
| IM | NO |
| IV Direct | NO |
| IV Intermittent Infusion |
YES Undiluted |
| IV Continuous Infusion | NO |
(For neonatal dosages, refer to Neonatal IV Drug Manual.)
Pediatric
-T-cell acute lymphoblastic leukemia, T-cell lymphoma, T-cell lymphoblastic lymphoma
650 mg/m2 IV over 1 hour daily for 5 consecutive days repeated every 21 days
Adult
-T-cell acute lymphoblastic leukemia, T-cell lymphoma, T-cell lymphoblastic lymphoma
1500 mg/m2 IV over 2 hours on days 1, 3, and 5 repeated every 21 days
- Dose-limiting toxicity of nelarabine is neurotoxicity. Observe closely for signs and symptoms (severe somnolence, confusion, convulsions, ataxia, paresthesia, coma, ascending neuropathy or craniospinal demyelination). If neurologic toxicity develops prior to completion of 5 days therapy, Nelarabine should be halted and the study chair should be contacted immediately. If Grade 4 Nelarabine-related neurotoxicity develops, the patient will be taken off Nelarabine indefinitely.
- Common adverse reactions - abdominal discomfort and pain, diarrhea, headache, somnolence, fever, edema and myelosuppression.
- Appropriate measures must be taken to prevent hyperuricemia or tumor lysis syndrome
- Non-vesicant
- Patients treated previously or concurrently with intrathecal chemotherapy or treated previously with craniospinal irradiation may be at increased risk for neurologic adverse events.
- Use caution in patients with renal impairment and with severe hepatic impairment.