Atriance

Drug name: Nelarabine (Atriance)

Drug alias: Nelarabine

English name: Atriance

R&D company: Novartis Pharmaceuticals

Indications: T Cellular acute lymphoblastic leukemia

Model specifications: 250mg/50ml

[Nelarabine (Atriance) indications]

It is used to treat patients with acute T-cell lymphoblastic leukemia (T-ALL) and T-cell lymphoblastic lymphoma (T-LBL) who have not responded to or relapsed at least two chemotherapy regimens.

[Nelarabine (Atriance) usage and dosage]

Adults: Adopt intravenous drip administration, the recommended dose is 1500mg/㎡, once a day, administered every other day for 5 days, with a cycle of 21 days.

Children: Use intravenous infusion, the recommended dose is 650mg/㎡, once a day for 5 consecutive days, with a cycle of 21 days.

[Adverse reactions of Nelarabine (Atriance)]

May reduce the number of white blood cells, causing symptoms such as fever, local symptoms such as sore throat or urinary problems, weakness and fatigue (temporary anemia), muscle weakness, Unusual bruising or bleeding, drowsiness, headache; dizziness, difficulty breathing, cough, nausea, diarrhea, constipation, muscle pain, loss of appetite, stomach pain, mouth sores, mouth ulcers or inflammation, blurred vision.

[Nelarabine (Atriance) Contraindications]

Contraindicated if you are allergic to Nelarabine or other ingredients in this medicine

[Nelarabine (Atriance Precautions)]

If you have kidney or liver problems, the dose may need to be adjusted

Not recommended for pregnancy and breastfeeding, including men

This medicine contains at least 23 mg of sodium per dose. Consideration should be given to the patient's sodium-controlled diet.

Use with caution in patients with hyperuricemia, bone marrow suppression, etc.

Appropriate measures must be taken when taking medication, such as hydration, urine alkalinization, and the use of allopurinol to prevent hyperuricemia caused by tumor lysis syndrome.

If the disease continues to progress during medication, the patient cannot tolerate the toxicity, the patient is about to undergo a bone marrow transplant, or continued treatment is ineffective, the medication needs to be discontinued.

The neurotoxicity of this drug is dose-limiting, and patients should be closely monitored for symptoms and signs of central nervous system toxicity when taking the drug.

Patients with severe hepatic and renal insufficiency are at increased risk of adverse reactions.

[Storage of Atriance]

Store in the dark below 25 degrees Celsius.

[Nelarabine (Atriance) mechanism of action]

Nelarabine is demethylated and converted into ara-G under the action of adenosine deaminase, monophosphorylated under the action of deoxyguanosine kinase and deoxyside kinase, and then converted into the active 5-triphosphate ara-GTP. Ara-GTP accumulates in leukemia blast cells to a certain extent and then becomes embedded in DNA, thereby inhibiting DNA synthesis and eventually leading to cell death. In addition, BeesleyAH et al. found that T cells are eight times more sensitive to nelarabine than B cells. Studies by E1ineJ et al. have shown that ara-GTP accumulates faster and in greater amounts in T cells than in B cells, and ara-GTP has a stronger selective cytotoxic effect on T cells.

[Safety and Efficacy of Nelarabine (Atriance)]

The FDA released a clinical research report on Nelarabine, dividing the patients participating in the trial into a pediatric group and an adult group. Adopt intravenous drip administration, and the dose in the children group is 650 mg·m-2·d-1 for 5 consecutive days. The adult group is 1500 mg·m-2·d-1 on days one, three and five. The treatment cycle is 21 days. The evaluation indicators are complete recovery response (CR) of blood or bone marrow and incomplete recovery response (CR*) of blood or bone marrow. The results showed that among the 39 patients in the pediatric group, 5 had a complete response (CR) to nelarabine, accounting for 13% of the total, and 9 had a complete response and partial recovery response (CR+CR*), accounting for 23% of the total. Among the 28 patients in the adult group, 5 had complete responses (CR), accounting for 18% of the total, and 6 had complete responses and partial recovery responses (CR+CR*), accounting for 21% of the total.