Can you take Alemtuzumab with Nelarabine?

Alemtuzumab has a major potential interaction with Bone Marrow Depression/Low Blood Counts.

Severe, including fatal, autoimmune anemia and thrombocytopenia, and prolonged myelosuppression have been reported in patients receiving alemtuzumab. It is recommended to withhold therapy for severe cytopenias and to discontinue therapy for autoimmune cytopenias or recurrent/persistent severe cytopenias (except lymphopenia). It is recommended to monitor complete blood counts (CBC) at weekly intervals during therapy and more frequently if worsening anemia, neutropenia, or thrombocytopenia occurs and to assess CD4+ counts after treatment until recovery to >= 200 cells/µL.

Alemtuzumab has a moderate potential interaction with Heart Disease.

The use of alemtuzumab can cause severe infusion reactions, including pyrexia, chills/rigors, nausea, hypotension, urticaria, dyspnea, rash, emesis, and bronchospasm. Caution should be taken in patients with a history of pulmonary disease, heart disease as they may require dose-escalation and additional pre-infusion medications to manage complications as appropriate.

Nelarabine has a major potential interaction with History, Radiation Therapy.

Severe neurologic adverse reactions have been reported with the use of nelarabine. Neurotoxicity is the dose-limiting toxicity of nelarabine. Patients treated previously or concurrently with intrathecal chemotherapy or previously with craniospinal irradiation may be at increased risk for neurologic adverse events. Close monitoring for neurologic adverse reactions is strongly recommended, when using nelarabine and therapy should be discontinued for neurologic adverse reactions of NCI Common Toxicity Criteria Grade 2 or greater.

Nelarabine has a moderate potential interaction with Hyperuricemia Secondary to Chemotherapy.

Patients receiving nelarabine should receive intravenous hydration according to standard medical practice for the management of hyperuricemia in patients at risk for tumor lysis syndrome. Consideration should be given to the use of allopurinol in patients at risk of hyperuricemia.

Alemtuzumab has a moderate potential interaction with Infection.

Alemtuzumab should be used with caution in patients at risk of opportunistic infections, as therapy could result in severe and prolonged lymphopenia. It is recommended to administer prophylaxis against Pneumocystis jiroveci pneumonia (PCP) and herpes viral during and for a minimum of 2 months after completion of therapy or until the CD4+ count is >=200 cells/µL. Routinely monitor patients for CMV infection during therapy and withhold therapy for serious infections and during antiviral treatment for CMV infection or confirmed CMV viremia.

Nelarabine has a moderate potential interaction with Liver Disease.

The influence of hepatic impairment on the pharmacokinetics of nelarabine has not been evaluated. Because the risk of adverse reactions to this drug may be greater in patients with severe hepatic impairment (total bilirubin greater than 3 times upper limit of normal), it is recommended to closely monitor patients with severe liver dysfunction when treated with nelarabine.

Nelarabine has a major potential interaction with Neurological Disorders.

Severe neurologic adverse reactions have been reported with the use of nelarabine. Neurotoxicity is the dose-limiting toxicity of nelarabine. Patients treated previously or concurrently with intrathecal chemotherapy or previously with craniospinal irradiation may be at increased risk for neurologic adverse events. Close monitoring for neurologic adverse reactions is strongly recommended, when using nelarabine and therapy should be discontinued for neurologic adverse reactions of NCI Common Toxicity Criteria Grade 2 or greater.

Alemtuzumab has a moderate potential interaction with Pulmonary Impairment.

The use of alemtuzumab can cause severe infusion reactions, including pyrexia, chills/rigors, nausea, hypotension, urticaria, dyspnea, rash, emesis, and bronchospasm. Caution should be taken in patients with a history of pulmonary disease, heart disease as they may require dose-escalation and additional pre-infusion medications to manage complications as appropriate.

Nelarabine has a moderate potential interaction with Renal Dysfunction.

Nelarabine has not been studied in patients with renal dysfunction. There are insufficient data to support a dose recommendation for patients with a CrCl less than 50 mL/min. Because the risk of adverse reactions to this drug may be greater in patients with moderate (CrCl 30 to 50 mL/min) or severe (CrCl less than 30 mL/min) renal impairment, these patients should be closely monitored for toxicities if treated with this drug.

Nelarabine has a moderate potential interaction with Tumor Lysis Syndrome.

Patients receiving nelarabine should receive intravenous hydration according to standard medical practice for the management of hyperuricemia in patients at risk for tumor lysis syndrome. Consideration should be given to the use of allopurinol in patients at risk of hyperuricemia.

Nelarabine has a major potential interaction with Vaccination.

Immunocompromised patients receiving nelarabine should avoid receiving live vaccines.