Side Effects of cladribine injection: A Synthesis of Findings from 12 Studies

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Original Abstract of the Article

Main Research Findings

Cladribine shows promise as a treatment for relapsing-remitting multiple sclerosis (RRMS). 10 found that cladribine had a statistically significant favorable effect on the joint frequency and severity of relapses and magnetic resonance imaging (MRI) findings. 3 suggests the potential for cladribine in oral immunotherapy for RMS. Additionally, cladribine is also used to treat hairy cell leukemia (HCL), with a study 12 reporting high remission rates in HCL patients.

Reasons for side effects

The side effects of cladribine are believed to be due to its immunosuppressive effects. Cladribine suppresses the immune system by reducing the number of lymphocytes, increasing the risk of infections. It can also suppress bone marrow function, potentially leading to side effects like anemia and thrombocytopenia. 9 demonstrated that cladribine accumulated in the skin, thymus, and bone marrow of mice.

Common side effects

Infections

Due to the immunosuppressive effects of cladribine, the risk of infections is elevated. 10 reported two cases of shingles in the cladribine group. 11 observed a decrease in lymphocyte subsets in the cladribine group. 5 mentions that cladribine and pentostatin may be associated with immunosuppression, stem cell toxicity, and potentially secondary malignancy. 2 reports lymphopenia as a side effect of cladribine administration.

Anemia

Cladribine can cause anemia by suppressing bone marrow function. 5 indicates that cladribine and pentostatin may cause stem cell toxicity.

Thrombocytopenia

Cladribine can cause thrombocytopenia due to its effect on bone marrow function. 5 suggests that cladribine and pentostatin may cause stem cell toxicity.

Other side effects

Cladribine can lead to side effects like nausea, vomiting, diarrhea, rash, and liver dysfunction. 3 reports lymphopenia as a side effect of oral cladribine administration. 4 suggests that the CLAT protocol, which combines cladribine, cytarabine, and topotecan, might be effective for treating refractory acute myeloid leukemia.

Side effects management

Infections

Infection prevention is crucial during cladribine treatment. Regular blood tests are necessary for early detection and treatment of infections. 5 emphasizes the need to evaluate the long-term adverse effects of cladribine and pentostatin.

Anemia

If symptoms of anemia occur, consult a doctor for necessary treatment.

Thrombocytopenia

If thrombocytopenia symptoms appear, seek medical advice and appropriate treatment.

Comparison between studies

Commonalities between studies

Cladribine holds promise as a treatment for both relapsing-remitting multiple sclerosis (RRMS) and hairy cell leukemia (HCL). 10 , 12 , and 3 report on the effectiveness and side effects of cladribine.

Differences between studies

The administration methods, dosages, and target diseases vary across studies. While 10 administered cladribine via subcutaneous injection, 3 used oral administration. 12 focused on treating hairy cell leukemia with cladribine, whereas other studies concentrated on multiple sclerosis. Comparing these findings allows for a deeper understanding of cladribine's effectiveness and side effects.

Considerations for real-life application

Cladribine's immunosuppressive effects elevate the risk of infections. It's crucial to prioritize infection prevention during cladribine treatment. Regular blood tests are essential for early detection and treatment of infections. Additionally, cladribine can cause anemia and thrombocytopenia due to its impact on bone marrow function. If these side effects arise, consult a doctor for appropriate management.

Limitations of current research

Further research is required to evaluate the long-term effectiveness and side effects of cladribine. 5 emphasizes the need for this assessment. Additionally, while cladribine is used to treat various diseases, the optimal administration methods and dosages for each condition remain unclear. 2 indicates the need for further investigation into these aspects.

Future research directions

Research focusing on evaluating the long-term effects and side effects of cladribine, determining optimal administration methods and dosages for different diseases, and unraveling the drug's novel mechanisms of action is necessary. 1 suggests that cladribine may impact the immune response to COVID-19 vaccines. More research is needed to understand the influence of cladribine on vaccine efficacy.

Conclusion

Cladribine holds promise as a treatment for relapsing-remitting multiple sclerosis (RRMS) and hairy cell leukemia (HCL). However, it's essential to acknowledge the potential risks of infections due to its immunosuppressive effects, and anemia and thrombocytopenia due to bone marrow suppression. When taking cladribine, follow medical instructions and undergo regular blood tests.

Literature analysis of 12 papers
Positive Content
12
Neutral Content
0
Negative Content
0
Article Type
1
0
0
4
12
2.

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

4.

[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

5.

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

6.

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

8.

Emerging oral drugs for multiple sclerosis.

Author: GasperiniClaudio, CefaroLuca Ausili, BorrielloGiovanna, TostoGiuseppe, ProsperiniLuca, PozzilliCarlo

MS treatment
Injection side effects
Patient adherence

New oral therapies for multiple sclerosis are needed as current treatments have limitations.

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

9.

Distribution of 2-chloro-2'-deoxyadenosine, 2-chloro-2'-arabino-fluoro-2'-deoxyadenosine, fludarabine and cytarabine in mice: a whole-body autoradiography study.

Author: LindemalmS, LiliemarkJ, LarssonB S, AlbertioniF

The distribution of the nucleoside analogs was rapid and uniform. High concentrations were found in highly perfused organs. After 4 h, relatively high activities were found in the skin for CdA and CAFdA, in the thymus for ara-C and the bone marrow for CdA. The nucleoside analog transport to the brain in mice is not primarily dependent upon passive diffusion over a lipophilic barrier, but suggestive of a specific transport mechanism.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
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

10.

A double-blind, placebo-controlled, randomized trial of cladribine in relapsing-remitting multiple sclerosis.

Author: RomineJ S, SipeJ C, KoziolJ A, ZyroffJ, BeutlerE

MS Treatment
Relapse Reduction
Herpes Zoster

Cladribine, a purine analog, showed promising results in treating relapsing-remitting multiple sclerosis in a placebo-controlled study. It significantly reduced relapse frequency and severity and suppressed MRI-enhancing lesions. Mild side effects, including segmental herpes zoster, were observed.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

11.

Safety and tolerability of subcutaneous cladribine therapy in progressive multiple sclerosis.

Author: SelbyR, BrandweinJ, O'ConnorP

CPMS treatment
Lymphocyte reduction
EDSS deterioration
Lymphocyte suppression

Subcutaneous cladribine therapy was well-tolerated in patients with chronic progressive multiple sclerosis (CPMS) at lower doses than previously reported. The drug significantly reduced lymphocyte subsets, particularly CD4, CD8, and CD19 cells, without causing significant myelosuppression.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

12.

[Progress in the treatment of hairy cell leukemia. Subcutaneous administration of 2-chloro-deoxy-adenosine for 7 days].

Author: HeldalD, TjønnfjordG E, EvensenS A, JuliussonG

High remission rate
Treat hairy cell leukemia
Unknown long-term effects

2-chloro-deoxy-adenosine (2-CdA) is a new and effective treatment for hairy cell leukemia, a rare chronic B-lymphocyte malignancy. 2-CdA, given subcutaneously for seven days, has shown encouraging results in a Nordic cooperative study, making it a promising treatment option.

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.
English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : Norwegian

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