Generic name: Cladribine
Trade names: Leustatin
Other names: 2-CdA
Care During Chemotherapy and Beyond
Chemocare.com uses generic names in all descriptions of drugs. Leustatin is the
trade name for Cladribine. 2-CdA and 2-Chlorodeoxyadenosine are other names for
Cladribine. In some cases, health care professionals may use the trade name Leustatin
or other names 2-CdA or 2-Chlorodeoxyadenosine when referring to the generic drug
Drug type: 2-Chlorodeoxyadenosine is an anti-cancer ("antineoplastic"
or "cytotoxic") chemotherapy drug. This medication is classified as an "antimetabolite."
(For more detail, see "How this drug works" section below).
What this drug is used for:
2-Chlorodeoxyadenosine is used to treat:
- hairy cell leukemia
- chronic lymphocytic leukemia (CLL)
- non-Hodgkin's lymphomas
Note: If a drug has been approved for one use, physicians may elect
to use this same drug for other problems if they believe it may be helpful.
How this drug is given:
- Cladribine is administered by infusion through a vein. The infusion may be
over 1-2 hours on consecutive days, or may be as a continuous infusion over several
days. The way it is given depends on the protocol.
- There is no pill form of cladribine.
- The amount of cladribine that you will receive depends on many factors, including
your height and weight, your general health or other health problems, and the type
of cancer or condition being treated. Your doctor will determine your dose
Important things to remember about the side effects of cladribine:
- Most people do not experience all of the side effects listed.
- Side effects are often predictable in terms of their onset and duration.
- Side effects are almost always reversible and will go away after treatment is complete.
- There are many options to help minimize or prevent side effects.
- There is no relationship between the presence or severity of side effects and the
effectiveness of the medication.
- Side effects of cladribine and their severity depend on how much of the drug is
given. In other words, high doses may produce more severe side effects.
The following side effects are common (occurring in greater than 30%) for
patients taking cladribine:
- Fever (incidence decreases with continued therapy)
- Low white blood cell count. (this can put you at risk for infection)
- Low red blood cell count (anemia)
Nadir: Meaning low point, nadir is the point in time between chemotherapy
cycles in which you experience low blood counts.
Onset: none noted
Nadir: 5-10 days
Recovery: 4-8 weeks
These are less common side effects (occurring in about 10-29%) of patients
- Nausea (mild), vomiting.
- Skin rash.
- Chills (see flu like symptoms).
- Skin reaction (redness, itching) at IV infusion site.
- Poor appetite.
- Low platelet count (increased risk of bleeding).
Note: You will be considered immunosuppressed (increased risk of
developing infection) for up to one year after taking cladribine.
Not all side effects are listed above, some that are rare (occurring in less than
10% of patients) are not listed here. However, you should always inform your
health care provider if you experience any unusual symptoms.
When to contact your doctor or health care provider:
Contact your health care provider immediately, day or night, if you
should experience any of the following symptoms:
- Fever of 100.4°F (38°C) or higher or chills (possible signs of infection).
The following symptoms require medical attention, but are not an emergency.
Contact your health care provider within 24 hours of noticing any of the
- Extreme fatigue (unable to carry on self-care activities).
- Nausea (interferes with ability to eat and unrelieved with prescribed medication).
- Vomiting (vomiting more than 4-5 times in a 24 hour period).
* Unusual bleeding or bruising.
- Black or tarry stools, or blood in your stools or urine.
Always inform your health care provider if you experience any unusual symptoms.
- Before starting cladribine treatment, make sure you tell your doctor about any other
medications you are taking (including prescription, over-the-counter, vitamins,
herbal remedies, etc.).
- Do not receive any kind of immunization or vaccination without your doctor's approval
while taking cladribine.
- Inform your health care professional if you are pregnant or may be pregnant prior
to starting this treatment. Pregnancy category D (cladribine may be hazardous to
the fetus. Women who are pregnant or become pregnant must be advised of the
potential hazard to the fetus).
- For both men and women: Do not conceive a child (get pregnant) while taking cladribine.
Barrier methods of contraception, such as condoms, are recommended. Discuss with
your doctor when you may safely become pregnant or conceive a child after therapy.
- Do not breast feed while taking this medication.
- To reduce nausea, take anti-nausea medications as prescribed by your doctor, eat
small amounts of food frequently.
- Drink at least two to three quarts of fluid every 24 hours, unless you are instructed
- You may be at risk of infection so try to avoid crowds or people with colds, and
report fever or any other signs of infection immediately to your health care provider.
- Wash your hands often.
- Use an electric razor and a soft toothbrush to minimize bleeding.
- Avoid contact sports or activities that could cause injury.
- In general, drinking alcoholic beverages should be kept to a minimum or avoided
completely. You should discuss this with your doctor.
- Avoid sun exposure. Wear SPF 15 (or higher) sunblock and protective clothing.
- Get plenty of rest.
- Maintain good nutrition.
- If you experience symptoms or side effects, be sure to discuss them with your health
care team. They can prescribe medications and/or offer other suggestions that
are effective in managing such problems.
Monitoring and testing:
You will be checked regularly by your doctor while you are taking cladribine, to
monitor side effects and check your response to therapy. Periodic blood work
to monitor your complete blood count (CBC) as well as the function of other organs
(such as your kidneys and liver) will also be ordered by your doctor.
How this drug works:
Cancerous tumors are characterized by cell division, which is no longer controlled
as it is in normal tissue. "Normal" cells stop dividing when they come
into contact with like cells, a mechanism known as contact inhibition. Cancerous
cells lose this ability. Cancer cells no longer have the normal checks and
balances in place that control and limit cell division. The process of cell
division, whether normal or cancerous cells, is through the cell cycle. The
cell cycle goes from the resting phase, through active growing phases, and then
to mitosis (division).
The ability of chemotherapy to kill cancer cells depends on its ability to halt
cell division. Usually, the drugs work by damaging the RNA or DNA that tells
the cell how to copy itself in division. If the cells are unable to divide,
they die. The faster the cells are dividing, the more likely it is that chemotherapy
will kill the cells, causing the tumor to shrink. They also induce cell suicide
(self-death or apoptosis).
Chemotherapy drugs that affect cells only when they are dividing are called cell-cycle
specific. Chemotherapy drugs that affect cells when they are at rest are called
cell-cycle non-specific. The scheduling of chemotherapy is set based on the
type of cells, rate at which they divide, and the time at which a given drug is
likely to be effective. This is why chemotherapy is typically given in cycles.
Chemotherapy is most effective at killing cells that are rapidly dividing.
Unfortunately, chemotherapy does not know the difference between the cancerous cells
and the normal cells. The "normal" cells will grow back and be healthy but in the
meantime, side effects occur. The "normal" cells most commonly affected by
chemotherapy are the blood cells, the cells in the mouth, stomach and bowel, and
the hair follicles; resulting in low blood counts, mouth sores, nausea, diarrhea,
and/or hair loss. Different drugs may affect different parts of the body.
Cladribine belongs to the class of chemotherapy drugs called antimetabolites.
Antimetabolites are very similar to normal substances within the cell. When
the cells incorporate these substances into the cellular metabolism, they are unable
to divide. Antimetabolites are cell-cycle specific. They attack cells
at very specific phases in the cycle. Antimetabolites are classified according
to the substances with which they interfere.
- Folic acid antagonist: Methotrexate.
- Pyrimidine antagonist: 5-Fluorouracil, Foxuridine, Cytarabine,
Capecitabine, and Gemcitabine.
- Purine antagonist: 6-Mercaptopurine and 6-Thioguanine.
- Adenosine deaminase inhibitor: Cladribine, Fludarabine and
Note: We strongly encourage you to talk with your health
care professional about your specific medical condition and treatments. The information
contained in this website is meant to be helpful and educational, but is not a substitute
for medical advice.
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