Cladribine underdosing in hairy-cell leukemia: a cause for apparent response failure.
While chemotherapy overdose is often readily discovered, underdosing errors are seldom appreciated. We report two patients with hairy-cell leukemia who apparently failed to respond to cladribine administered by continuous portable pump infusion. It was determined that both patients received one-seventh of the prescribed dose, although the orders were written correctly. The errors resulted in the administration of 1 day's dose over 1 week. The use of 7-day portable pump infusion therapy for cladribine can be associated with misdosing, and is an occult cause of apparent failure to respond in hairy-cell leukemia.
Golde
David W
DW
Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA. d-golde@ski.mskcc.org
Jakubowiak
Andrzej
A
Caggiano
Janine
J
Heaney
Mark L
ML
D017338:Cladribine / Q000008:administration & dosage*; D006801:Humans; D007263:Infusions, Parenteral / Q000009:adverse effects; D007943:Leukemia, Hairy Cell / Q000188:drug therapy*; D008297:Male; D008508:Medication Errors / Q000295:instrumentation; D008875:Middle Aged; D017211:Treatment Failure
D017338:Cladribine