Care During Chemotherapy and Beyond
(klo FARE a been)
Trade name: Clolar
Clofarabine is the generic name for the trade name chemotherapy drug Clolar®. In some cases, health care professionals may use the trade name Clolar® when
referring to the generic name clofarabine.
Clofarabine is an anti-cancer ("antineoplastic" or "cytotoxic") chemotherapy drug. This medication is classified as an "antimetabolite." (For more detail,
see "How this drug works" section below).
What Clofarabine Is Used For:
- Indicated for the treatment of pediatric patients, 1 to 21 years old, with relapsed or refractory acute lymphoblastic leukemia (ALL) after at least 2
If a drug has been approved for one use, physicians may elect to use this same drug for other problems if they believe it may be helpful.
How Clofarabine Is Given:
- Clofarabine is given through a vein by intravenous injection (IV).
The amount of clofarabine that you will receive depends on many factors, including your age, height and weight, your general health or other health
problems, and the type of cancer or condition being treated. Your doctor will determine your dose and schedule.
Clofarabine Side Effects:
- Most people do not experience all of the side effects listed.
- Side effects are often predictable in terms of their onset and duration.
- Side effects are almost always reversible and will go away after treatment is complete.
- There are many options to help minimize or prevent side effects.
- There is no relationship between the presence or severity of side effects and the effectiveness of the medication.
The following side effects are common (occurring in greater than 30%) for patients taking clofarabine:
These side effects are less common side effects (occurring in about 10-29%) of patients receiving clofarabine:
Not all side effects are listed above. Some that are rare (occurring in less than 10% of patients) are not listed here. However, you should always
inform your health care provider if you experience any unusual symptoms.
When to contact your doctor or health care provider:
Contact your health care provider
, day or night, if you should experience any of the following symptoms and go to the Emergency Room:
- Fever of 100.4° F (38° C) or higher, chills (possible signs of infection)
- Signs of a reaction to the medication (wheezing; chest tightness; fever; itching; bad cough; blue or grey skin color; seizures; or swelling of the face,
lips, tongue or throat.
The following symptoms require medical attention, but are not an emergency. Contact your health care provider
within 24 hours
of noticing any of the following:
- Yellowing of the skin or eyes
- Unusual bleeding or bruising
- Black or tarry stools, or blood in your stools or urine
- Very bad headache
- Not able to pass urine
- Change in thinking clearly and with logic
- Extreme fatigue (unable to carry on self-care activities)
- Nausea (interferes with ability to eat and unrelieved with prescribed medication)
- Vomiting (vomiting more than 4-5 times in a 24 hour period)
- Diarrhea (4-6 episodes in a 24-hour period)
- Mouth sores (painful redness, swelling or ulcers)
- A burning or tingling that is not normal
- Very bad skin irritation
- Any rash
- Other signs of infection such as very bad sore throat, ear or sinus pain, cough,
more sputum or change in the color of the sputum, painful urination, mouth sores,
wound that will not heal, or anal itching or pain
Always inform your health care provider if you experience any unusual symptoms.
Before starting clofarabine treatment, make sure you tell your doctor about any other medications you are taking (including prescription,
over-the-counter, vitamins, herbal remedies, etc.). Do not receive any kind of immunization or vaccination without your doctor's approval while taking
Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment. Pregnancy category D (clofarabine may be
hazardous to the fetus. Women who are pregnant or become pregnant must be advised of the potential hazard to the fetus).
For both men and women: Do not conceive a child (get pregnant) while taking clofarabine. Barrier methods of contraception, such as condoms, are
recommended. Discuss with your doctor when you may safely become pregnant or conceive a child after therapy.
Do not breast feed while taking this medication.
Drink at least two to three quarts of fluid every 24 hours, unless you are instructed otherwise.
You may be at risk of infection so try to avoid crowds or people with colds and those not feeling well, and report fever or any other signs of infection
immediately to your health care provider.
Wash your hands often.
To help treat/prevent mouth sores, use a soft toothbrush, and rinse three times a day with 1/2 to 1 teaspoon of baking soda and/or 1/2 to 1 teaspoon of
salt mixed with 8 ounces of water.
Use an electric razor and a soft toothbrush to minimize bleeding.
Avoid contact sports or activities that could cause injury.
If you should experience nausea, take anti-nausea medications as prescribed by your doctor, and eat small frequent meals. Sucking on lozenges and chewing
gum may also help.
Avoid sun exposure. Wear SPF 15 (or higher) sun block and protective clothing.
In general, drinking alcoholic beverages should be kept to a minimum or avoided completely. You should discuss this with your doctor.
Get plenty of rest.
Maintain good nutrition.
If you experience symptoms or side effects, be sure to discuss them with your health care team. They can prescribe medications and/or offer other
suggestions that are effective in managing such problems.
Monitoring and Testing:
You will be checked regularly by your health care professional while you are taking clofarabine, to monitor side effects and check your response to
therapy. Periodic blood work to monitor your complete blood count (CBC) as well as the function of other organs (such as your kidneys and liver) will also
be ordered by your doctor.
How Clofarabine Works:
Cancerous tumors are characterized by cell division, which is no longer controlled as it is in normal tissue. "Normal" cells stop dividing when they come
into contact with like cells, a mechanism known as contact inhibition. Cancerous cells lose this ability. Cancer cells no longer have the normal checks and
balances in place that control and limit cell division. The process of cell division, whether normal or cancerous cells, is through the cell cycle. The
cell cycle goes from the resting phase, through active growing phases, and then to mitosis (division).
The ability of chemotherapy to kill cancer cells depends on its ability to halt cell division. Usually, the drugs work by damaging the RNA or DNA that
tells the cell how to copy itself in division. If the cells are unable to divide, they die. The faster the cells are dividing, the more likely it is that
chemotherapy will kill the cells, causing the tumor to shrink. They also induce cell suicide (self-death or apoptosis).
Chemotherapy drugs that affect cells only when they are dividing are called cell-cycle specific. Chemotherapy drugs that affect cells when they are at rest
are called cell-cycle non-specific. The scheduling of chemotherapy is set based on the type of cells, rate at which they divide, and the time at which a
given drug is likely to be effective. This is why chemotherapy is typically given in cycles.
Chemotherapy is most effective at killing cells that are rapidly dividing. Unfortunately, chemotherapy does not know the difference between the cancerous
cells and the normal cells. The "normal" cells will grow back and be healthy but in the meantime, side effects occur. The "normal" cells most commonly
affected by chemotherapy are the blood cells, the cells in the mouth, stomach and bowel, and the hair follicles; resulting in low blood counts, mouth
sores, nausea, diarrhea, and/or hair loss. Different drugs may affect different parts of the body.
Clofarabine belongs to the class of chemotherapy drugs called antimetabolites. Antimetabolites are very similar to normal substances within the cell. When
the cells incorporate these substances into the cellular metabolism, they are unable to divide. Antimetabolites are cell-cycle specific. They attack cells
at very specific phases in the cycle. Antimetabolites are classified according to the substances with which they interfere.
Folic acid antagonist:
5-fluorouracil, foxuridine, cytarabine, capecitabine, and gemcitabine.
6-mercaptopurine, 6-thioguanine and clofarabine.
Adenosine deaminase inhibitor:
cladribine, fludarabine and pentostatin.
We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in
this website is meant to be helpful and educational, but is not a substitute for medical advice.
Chemocare.com is designed to provide the latest information about chemotherapy to patients and their families, caregivers and friends. For information about the 4th Angel Mentoring Program visit www.4thangel.org