Effects of cladribine injection: A Synthesis of Findings from 23 Studies

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Original Abstract of the Article

Major Findings

Cladribine, a purine nucleoside analog, has been used to treat hairy cell leukemia for over 30 years. 15 A single course of cladribine given as a subcutaneous injection for 7 days can induce complete remission in most patients with hairy cell leukemia. 15 Cladribine has also been investigated as a potential treatment for multiple sclerosis. 21 It has shown efficacy in all stages of multiple sclerosis. 3 Cladribine treatment is associated with depletion of memory B cells. 4 A study in rats found that cladribine treatment inhibited cell proliferation and induced apoptosis in ovarian surface epithelial cells. 9 Cladribine also induces apoptosis in fallopian tube epithelial cells through the intrinsic pathway. 8 Cladribine has also been used in combination with rituximab to treat Waldenstrom’s macroglobulinemia. 16 This combination therapy has been found to be safe and effective. 16

Benefits and Risks

Benefit Summary

Cladribine is an effective treatment for hairy cell leukemia, multiple sclerosis, and Waldenstrom’s macroglobulinemia. 15 、 21 、 16 、 20 Subcutaneous injection of cladribine is effective and oral formulations are under development. 14 、 13 、 18 、 5

Risk Summary

Cladribine is an immunosuppressant and can increase the risk of infections. 15 、 12 、 17 、 2 It can also cause side effects such as lymphoma. 15 、 12 Cladribine has been shown to inhibit cell proliferation and induce apoptosis in ovarian surface epithelial cells in rats. 9 Cladribine can also induce apoptosis in fallopian tube epithelial cells. 8

Comparison Across Studies

Similarities

Multiple studies have shown that cladribine is effective in treating hairy cell leukemia, Waldenstrom’s macroglobulinemia, and multiple sclerosis. 15 、 21 、 16 、 20 、 13 、 18 、 5 Cladribine is an immunosuppressant and can cause side effects such as infection and lymphoma. 15 、 12 、 17 、 2

Differences

The dosage and route of administration of cladribine vary across studies. 15 、 14 、 13 、 18 、 5 The effectiveness and side effects of cladribine also vary across studies. 15 、 12 、 17 、 2

Consistency and Contradictions of Findings

Cladribine is a proven effective treatment for hairy cell leukemia, Waldenstrom’s macroglobulinemia, and multiple sclerosis. 15 、 21 、 16 、 20 、 13 、 18 、 5 However, the effectiveness and side effects of cladribine vary across studies and further research is needed. 15 、 12 、 17 、 2

Considerations for Real-World Application

Cladribine should be used only under the guidance of a physician. 15 、 21 、 16 、 20 It is important to be aware of the risks of infection and lymphoma when using cladribine. 15 、 12 、 17 、 2 Cladribine may also affect ovarian surface epithelial cells and fallopian tube epithelial cells. 9 、 8 Consult your doctor before using cladribine.

Limitations of Current Research

More research is needed to fully understand the effects and side effects of cladribine. 15 、 12 、 17 、 2 Long-term effects of cladribine are still unknown. 15 、 12 、 17 、 2

Future Directions for Research

Further research is needed to better understand the effects and side effects of cladribine. 15 、 12 、 17 、 2 It is especially important to conduct research on the long-term effects of cladribine. 15 、 12 、 17 、 2

Conclusion

Cladribine is a proven effective treatment for hairy cell leukemia, Waldenstrom’s macroglobulinemia, and multiple sclerosis, but it is important to be aware of the risks of infection and lymphoma. 15 、 21 、 16 、 20 、 12 、 17 、 2 It is important to consult your doctor and understand the risks and benefits of cladribine before using it.

Literature analysis of 23 papers
Positive Content
20
Neutral Content
1
Negative Content
2
Article Type
0
0
0
9
23
3.

Treating the ineligible: Disease modification in people with multiple sclerosis beyond NHS England commissioning policies.

Author: MaoZhifeng, Álvarez-GonzálezCésar, Allen-PhilbeyKimberley, De TraneStefania, YildizOzlem, CampionTom, AdamsAshok, TurnerBenjamin P, MartaMonica, GnanapavanSharmilee, EspasandinMaria, MathewsJoela, GiovannoniGavin, BakerDavid, SchmiererKlaus

Cladribine safety
MS treatment
Lymphopenia

Cladribine, a medication for multiple sclerosis, was withdrawn from the market in 2011 due to lymphopenia. This study investigated the real-life safety and tolerability of subcutaneously injected cladribine.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

6.

[Indeterminate cell histiocytosis - disappearance of skin infiltration following electron beam therapy and an application of 2-chlorodeoxyadenosine: case report].

Author: AdamZdeněk, JežováMarta, ŠlampaPavel, KřenLeoš, VaškůVladimír, KoukalováRenata, ŘehákZdeněk, PourLuděk, KrejčíMarta, KrálZdeněk, MayerJiří

Indeterminate cell histiocytosis treatment

Indeterminate cell histiocytosis is a rare disease that affects the skin. It was diagnosed in an 80-year-old patient who had skin lesions that spread rapidly. The treatment involved PUVA phototherapy, low-energy electron beam irradiation, and 2-chlorodeoxyadenosine. While the disease went into remission after treatment, it recurred after 6 months.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : Czech

7.

[Effectiveness of CLAT Protocol for Treating Patients with Refractory Acute Myeloid Leukemia].

Author: ChenXiao-Mei, WengJian-Yu, DengCheng-Xin, WangYu-Lian, ChaoZhi, LaiPei-Long, LiMin-Ming, LiaoPeng-Jun, HuangXin, LingWei, WanChang-Chun, WuSui-Jing, ZhongLi-Ye, LuZe-Sheng, ZouXiao-Li, DUXin

Refractory AML treatment
Granulocytopenia
Infection
Thrombocytopenia

The CLAT protocol (cladribine, cytarabine, and topotecan) achieved a 66.7% response rate in patients with refractory acute myeloid leukemia, with a median overall survival time of 9.5 months.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : Chinese

8.

Intrinsic apoptosis pathway in fallopian tube epithelial cells induced by cladribine.

Author: Wawryk-GawdaEwelina, Chylińska-WrzosPatrycja, Lis-SochockaMarta, BulakKamila, Jodłowska-JędrychBarbara

Reproductive system damage

Cladribine, a purine nucleoside analog, induces apoptosis in oviduct epithelial cells through the intrinsic pathway, suggesting potential reproductive effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

10.

Emerging oral drugs for relapsing-remitting multiple sclerosis.

Author: GasperiniClaudio, RuggieriSerena

MS treatment
Side effects

Multiple sclerosis is an autoimmune disease of the central nervous system. Although there are now several therapies, many patients experience suboptimal response and side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

13.

Development of oral immunomodulatory agents in the management of multiple sclerosis.

Author: NicholasRichard, GiannettiPaolo, AlsanousiAli, FriedeTim, MuraroPaolo A

Reduces relapses
Long disease course
Side effects

Five oral therapies for multiple sclerosis (MS) are now available: cladribine, fingolimod, laquinimod, BG-12, and teriflunomide. These therapies are more convenient than injectable therapies, but they also have side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

14.

Hairy cell leukemia: epidemiology, pharmacokinetics of cladribine, and long-term follow-up of subcutaneous therapy.

Author: JuliussonGunnar, SamuelssonHenrik,

Hairy cell leukemia treatment
Secondary cancers

Cladribine, a prodrug used to treat hairy cell leukemia, has a long-term survival rate of >80% in patients under 60 years of age, but <50% in older patients.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

15.

Purine analog toxicity in patients with hairy cell leukemia.

Author: TadmorTamar

Complete remission
HCL treatment
Immune suppression
Secondary malignancy
Stem cell toxicity

The toxicity of cladribine and pentostatin in the treatment of hairy cell leukemia was reviewed.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

16.

Rituximab and subcutaneous 2-chloro-2'-deoxyadenosine as therapy in untreated and relapsed Waldenström's macroglobulinemia.

Author: LaszloD, AndreolaG, RigacciL, FabbriA, RabascioC, PintoA, NegriM, MartinelliG

Effective WM treatment
Predictive marker
Safe WM treatment
No NHL transformation
No major infections
No myelodysplasia

The efficacy of subcutaneous cladribine in combination with rituximab in patients with Waldenstrom macroglobulinemia was assessed.

Clinical Trial, Phase IIA Phase II trial is a trial that further evaluates the efficacy and safety of a new drug or treatment, whose safety has been confirmed to some extent in a Phase I trial, in a small number of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.

Language : English

17.

Oral therapies for multiple sclerosis: a review of agents in phase III development or recently approved.

Author: GoldRalf

Improved compliance
Oral MS treatment
Novel safety concerns

This article reviews the current state of oral therapies for multiple sclerosis (MS). While oral therapies offer convenience and improved patient compliance, careful consideration of their safety and tolerability profiles is crucial.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

18.

Emerging oral agents for multiple sclerosis.

Author: FoxEdward J

Improved adherence
Improved efficacy
Tolerable side effects
Long-term safety unknown

This article reviews the mechanisms of action, efficacy, and safety and tolerability of 4 emerging oral therapies for MS: cladribine, laquinimod, fingolimod, and dalfampridine. Cladribine, laquinimod, and fingolimod have demonstrated impressive efficacy in terms of clinical outcomes, such as annualized relapse rate and change in disability scores, as well as magnetic resonance imaging variables.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

19.

Emerging therapies in relapsing-remitting multiple sclerosis.

Author: MarriottJames J, O'ConnorPaul W

Convenience
RRMS treatment
Fatal complications
Side effects

This study reviewed the current and future of disease-modifying therapies (DMTs) for relapsing-remitting multiple sclerosis (RRMS). The researchers highlighted the need to weigh the convenience of oral DMTs against the relative inconvenience but long-term safety of current first-line injectable therapies.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

20.

Rituximab and subcutaneous 2-chloro-2'-deoxyadenosine combination treatment for patients with Waldenstrom macroglobulinemia: clinical and biologic results of a phase II multicenter study.

Author: LaszloDaniele, AndreolaGiovanna, RigacciLuigi, FabbriAlberto, RabascioCristina, MancusoPatrizia, PruneriGiancarlo, RadiceDavide, PintoAntonello, FrigeriFerdinando, CalabreseLiliana, BillioAtto, BertoliniFrancesco, MartinelliGiovanni

Treatment of WM

This study assessed the efficacy of 2-chloro-2'-deoxyadenosine (2-CdA) given subcutaneously in combination with rituximab in the treatment of newly diagnosed/pretreated patients with Waldenström macroglobulinemia (WM).

Clinical Trial, Phase IIA Phase II trial is a trial that further evaluates the efficacy and safety of a new drug or treatment, whose safety has been confirmed to some extent in a Phase I trial, in a small number of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

21.

Emerging multiple sclerosis oral therapies.

Author: RammohanKottil W, ShoemakerJennifer

Reduced lesion activity
Reduced relapse rates
Adverse effects

Five oral medications for Multiple Sclerosis (MS) are being evaluated in clinical trials. While they show promise in reducing relapse rates and lesion activity, their safety and tolerability are still being assessed.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

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