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Nelarabine Dosage

Medically reviewed on August 4, 2017.

Applies to the following strengths: 5 mg/mL

Usual Adult Dose for Acute Lymphoblastic Leukemia

Initial dose: 1,500 mg/m2 administered intravenously over 2 hours on days 1, 3, and 5 repeated every 21 days

The dose is administered as a two-hour infusion in adult patients.

Usual Adult Dose for Lymphoma

Initial dose: 1,500 mg/m2 administered intravenously over 2 hours on days 1, 3, and 5 repeated every 21 days

The dose is administered as a two-hour infusion in adult patients.

Usual Pediatric Dose for Acute Lymphoblastic Leukemia

Initial dose: 650 mg/m2 administered intravenously over 1 hour daily for 5 consecutive days repeated every 21 days.

The dose is administered as a one-hour infusion in pediatric patients.

Usual Pediatric Dose for Lymphoma

Initial dose: 650 mg/m2 administered intravenously over 1 hour daily for 5 consecutive days repeated every 21 days.

The dose is administered as a one-hour infusion in pediatric patients.

Renal Dose Adjustments

There is insufficient data to support a dose recommendation for CRCL <50 mL/min.

Liver Dose Adjustments

Data not available

Precautions

US BOXED WARNINGS:
-This drug has caused severe neurologic adverse reactions including altered mental states (e.g., severe somnolence), central nervous system effects (e.g., convulsions), and peripheral neuropathy ranging from numbness and paresthesia to motor weakness and paralysis. There have also been reports of adverse reactions associated with demyelination, and ascending peripheral neuropathies similar to Guillain-Barre syndrome.
-Full recovery from these events has not always occurred with cessation of therapy. Patients should be monitored for neurologic adverse reactions and therapy should be discontinued for neurologic adverse reactions of NCI Common Toxicity Criteria Grade 2 or greater.

Consult WARNINGS section for additional precautions.

Dialysis

There are insufficient data to support a dose recommendation for CRCL <50 mL/min.

Other Comments

Nelarabine is not diluted prior to administration.

The recommended duration of treatment for adult and pediatric patients has not been clearly established. In clinical trials, treatment was generally continued until there was evidence of disease progression, the patient experienced unacceptable toxicity, the patient became a candidate for bone marrow transplant, or the patient no longer benefited from treatment.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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