Chemo Experts, the easiest way to learn about cancer treatment
Find a Treatment:
Cancer Types
or
Treatments
listen

Tap along the timeline to move to different parts of the audio file.

Treatment Name: Nelarabine (Arranon®)

Nelarabine (Arranon®) is a Chemotherapy Regimen for Acute Lymphoid Leukemia (ALL)

How does nelarabine work?
Nelarabine is designed to kill leukemia cells, specifically leukemic T-cells. Nelarabine has not been proven effective in ALL involving B-cells; therefore it is only used to treat Acute Lymphoid Leukemia (ALL) involving T-cells.

Goals of therapy:
Nelarabine is given to alleviate the symptoms of ALL and restore normal bone marrow function. Nelarabine is given with the goal of achieving disease remission, and possibly a cure. If remission is achieved, some patients may receive a bone marrow transplant with the goal of cure.

listen

Tap along the timeline to move to different parts of the audio file.

Schedule

  • Nelarabine intravenous (IV) infusion, usually given over two hours on Days 1, 3, and 5 of each cycle

Nelarabine is usually given in an outpatient infusion center, allowing the person to go home afterwards.

Nelarabine is repeated every 21 days. This is known as one Cycle. Typically, a bone marrow biopsy is done after one cycle of therapy. If leukemia is still present, another cycle can be given to try and achieve disease remission. If there is no leukemia present after one or two cycles, patients can either be monitored, proceed to bone marrow transplant, or receive up to two additional cycles of nelarabine.

Click here for the common Nelarabine starting dose.

listen

Tap along the timeline to move to different parts of the audio file.

Side Effects

In clinical studies, the most commonly reported nelarabine (Arranon®) side effects are shown here:

On average, 8% of patients discontinue nelarabine due to unacceptable side effects.

Side effect videos Side Effect Videos
Fatigue Fatigue Neutropenic FeverNeutropenic FeverDiarrheaDiarrheaPainPain

listen

Tap along the timeline to move to different parts of the audio file.

Monitoring

How often monitoring needed?
Labs (blood tests) will be checked before treatment, daily while in the hospital, then periodically in clinic. Labs often include: Complete Blood Count (CBC), Comprehensive Metabolic Panel (CMP), uric acid, Lactate DeHydrogenase (LDH), plus any others your doctor may order.

How often is imaging needed?
Imaging may be checked during therapy if there is concern for a blood clot or infection. Imaging may include: X-rays or Computerized Tomography (CT) scans.

How might blood test results/imaging affect treatment?
Depending upon the bone marrow results during treatment with nelarabine, your doctor may advise to continue chemotherapy as planned or switch to a different therapy.

listen

Tap along the timeline to move to different parts of the audio file.

ChemoExperts Tips

  • You may receive the following treatments in the hospital before receiving nelarabine to help prevent tumor lysis syndrome: intravenous (IV) fluids, urine alkalinization, and an oral drug called allopurinol
  • A pharmacist should ALWAYS review your medication list to ensure that drug interactions are prevented or managed appropriately
  • Clinical trials may exist for ALL. Ask your doctor if any studies are currently enrolling in your area. If not, go to clinicaltrials.gov to search for other centers offering study medications

Patient Assistance & Co-payment Coverage

Patients under the age of 65 years, or those with private insurance plans:
If you have insurance and are looking for patient assistance or copay assistance for Nelarabine (Arranon®), we have provided links that may help.

Visit our Patient Assistance page and click the links to various patient assistance programs for help paying for Nelarabine (Arranon®). Depending upon your income, they may be able to help cover the cost of:

  • Nelarabine

For Branded medications (may be available for generic medications too), check with the manufacturer to determine if a co-pay card is offered and if it could reduce your monthly copay.

  • If you are uninsured, check with the manufacturer to determine if you are eligible to receive medication at no cost.

Medicare and Medicaid patients (Patients 65 years or older):
The clinic providing treatment will likely pre-authorize medications and immune therapies such as Nelarabine (Arranon®) and are the best source to help you understand drug cost.

  • Ask to speak with a patient assistance technician or financial counselor at the clinic or hospital administering this therapy.

Emotional Wellness

What is Emotional Wellness?
Emotional wellness is having a positive outlook balanced with a realistic understanding of current life events. This requires both an awareness and acceptance of your emotions. It is with this knowledge that you can develop a plan to take the necessary actions to positively impact your life.

Emotional wellness uses an ongoing process to continually reflect on the stressors of life in a constructive manner to move forward and create happiness.

Because emotional wellness is deeply connected with physical, social, and spiritual wellness, pursuing it often becomes particularly difficult in times of major illness. Despite this difficulty, working toward emotional wellness has been connected to improved treatment outcomes and a higher likelihood of achieving goals of therapy.

Learn more about pursuing emotional wellness while receiving treatment with Nelarabine (Arranon®)

Individual Drug Label Information

Nelarabine (Arranon®)

  • Nelarabine is an intravenous infusion
  • Strong caution for neurotoxicity. Symptoms of neurotoxicity include extreme tiredness, confusion, seizures, loss of coordination, numbness in fingers and toes, and muscle weakness. Notify doctor immediately if you experience any of these signs or symptoms 
General Nelarabine (Arranon) Side Effects 
  • Low white blood cells, red blood cells, and platelets are common 
  • Click on the nelarabine (Arranon) package insert below for reported side effects and possible drug interactions

Side Effect Videos
DiarrheaDiarrheaFatigue Fatigue PainPainNeutropenic FeverNeutropenic Fever

See DailyMed package insert.

Share this page:

References

DeAngelo DJ, Yu D, Johnson JL, et al. Nelarabine induces complete remissions in adults with relapsed or refractory T-lineage acute lymphoblastic leukemia or lymphoblastic lymphoma: Cancer and Leukemia Group B study 19801. Blood. 2007;109:5136-5142.

Created: September 28, 2015 Updated: November 1, 2016

What is Acute Lymphoid Leukemia (ALL)?

Acute Lymphoid Leukemia (ALL), also known as acute lymphoblastic leukemia, is a disease of the lymphoid cells found in the bone marrow. Lymphoid cells are responsible for developing into cells of the immune system called B-cells, T-cells, or Natural Killer cells. In ALL, immature lymphoid cells know as "blasts" replicate at a very fast rate. Sometimes blasts crowd out the normal cells in the bone marrow so that red blood cells or platelets are unable to develop.

Common symptoms of ALL include fatigue, infection, and bruising or bleeding. ALL is the most common cancer diagnosed in children, but is rare in adults. Most cases of ALL are considered "de novo" meaning that the cause is unknown; however, some cases can be linked to certain genetic syndromes. There is no staging system for ALL. Chromosomes are often analyzed to determine which mutations in the chromosomes exist. The effectiveness of the treatment may depend upon the specific chromosome mutations that are present.

NOTE: Treatment Options listed below are not all-inclusive. Other treatments may be available. ChemoExperts provides drug information and does not recommend any one treatment over another. Only your Doctor can choose your therapy.

What is Tumor Lysis Syndrome?

Tumor lysis syndrome occurs when many cancer cells die quickly and release their contents into the bloodstream. Many times the body has the ability to flush these substances out through the kidneys or metabolize them via the liver. However, sometimes the body needs medicines to help eliminate these substances and to prevent organ damage.

Common Nelarabine Starting Dose

  • Nelarabine 1500 mg/m2 IV over 2 hours on Days 1, 3, and 5 of each 21-day cycle

Note: Individual doses may vary based upon your doctor's recommendation, or drug availability.

What is a CBC?

A Complete Blood Count (CBC) is a frequently ordered blood test that tells clinicians the status of your: 1) White blood cell count, 2) Hemoglobin, and 3) Platelet count at the time the test was taken.

Common uses:
1) White blood cell count (WBC): is used to determine infection risk, or response to chemotherapy. Certain chemotherapy agents may harm our good infection-fighting cells. Sometimes chemotherapy may need to be delayed to allow these cells to recover.

2) Hemoglobin: is used to determine if someone is anemic. Anytime the hemoglobin is below 12 g/dL, the person is said to be anemic. Red blood cell transfusions, and sometimes iron can be given to restore the hemoglobin level, but anemia treatment should always aim at treating the underlying cause or condition.

3) Platelet count: is used to determine if the risk of bleeding is increased or if a platelet transfusion is required to prevent bleeding. Certain medications that increase bleeding risk, such as: aspirin, certain chemotherapy agents, and blood thinners, may need to be stopped temporarily until the platelet count is within a safe range.

What is a CMP?

A Comprehensive Metabolic Panel (CMP) is a frequently ordered blood test that tells clinicians the status of your: 1) Electrolytes & Acid/Base status2) Kidney function, 3) Liver function, 4) Blood sugar, and 5) Calcium at the time the test was taken. It is commonly used to monitor liver and kidney function when beginning new medications such as chemotherapy. A total of 14 tests are run simultaneously and are shown below.

Electrolytes & Acid/Base status:
1) Sodium, 2) Potassium, 3) Carbon dioxide, 4) Chloride

Kidney Function:
5) BUN (blood urea nitrogen), 6) Serum creatinine (Scr)

Liver Function:
7) AST, 8) ALT, 9) Total bilirubin, 10) Alk Phos, 11) Albumin, 12) Total protein

Blood sugar:
13) Serum glucose

Calcium:
14) Serum calcium

What is Tumor Lysis Syndrome?

Tumor lysis syndrome occurs when many cancer cells die quickly and release their contents into the bloodstream. Many times the body has the ability to flush these substances out through the kidneys or metabolize them via the liver. However, sometimes the body needs medicines to help eliminate these substances and to prevent organ damage.