Effect of hemodialysis on the plasma levels of clofarabine.
Clofarabine, a nucleoside analogue for treatment of relapsed leukemia, is 50-60% excreted in urine. Clofarabine has not been studied in patients on hemodialysis. We measured levels in one patient in acute renal failure. Prior to dialysis, 43 hr after a 40 mg/m(2) infusion, plasma concentration was 139 ng/ml. One hour after beginning hemodialysis, a 20 mg/m(2) infusion began. Plasma concentrations were 84.2, 81.1, and 88.0 ng/ml while the dialysis and clofarabine infusion occurred simultaneously. Post-dialysis, while the clofarabine was still infusing, the level was 95.8 ng/ml. Hemodialysis does decrease clofarabine levels, but given its large volume distribution, hemodialysis may not be effective for clofarabine overdose.
Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, New York, USA. steinhep@mskcc.org
Peter G
PG
Steinherz
Neerav
N
Shukla
Rachel
R
Kobos
Sheron
S
Latcha
D058186:Acute Kidney Injury / Q000097:blood / Q000175:diagnosis / Q000628:therapy*; D000227:Adenine Nucleotides / Q000097:blood* / Q000627:therapeutic use; D001087:Arabinonucleosides / Q000097:blood* / Q000627:therapeutic use; D000077866:Clofarabine; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000097:blood / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D006435:Renal Dialysis; D016896:Treatment Outcome; D055815:Young Adult
D000227:Adenine Nucleotides; D001087:Arabinonucleosides; D000077866:Clofarabine