Safety of nelarabine in adults with relapsed or refractory T-cell acute lymphoblastic leukemia/lymphoma.
INTRODUCTION
T-cell acute lymphoblastic leukemia (T-ALL) and lymphoma (T-LBL) are aggressive hematological malignancies accounting for 15-20% of adult acute lymphoproliferative diseases. Treatment of relapsed/refractory (R/R) T-ALL/T-LBL is challenging with very few therapeutic options.


AREAS COVERED
This report provides a concise review on the efficacy and safety of nelarabine monotherapy in adults with R/R T-ALL and T-LBL.


EXPERT OPINION
Nelarabine is approved for the treatment of adults with R/R T-ALL/T-LBL in the setting of third or more line of therapy. Hematological and neurological toxicities are the most frequent adverse events. Grade 3 and 4 neutropenia and thrombocytopenia are common, however with treatment-related deaths accounting only for 1-2% of patients. Neurological toxicity is typically characterized by a reversible peripheral neuropathy, usually mild or moderate and without treatment delay. Other neurological (somnolence and depressed level of consciousness) or extra-neurological adverse events are uncommon and rarely severe. In conclusion, nelarabine is a well tolerated and effective salvage therapy in patients with R/R T-ALL/T-LBL and has acquired an important role as a bridge-therapy to allogeneic stem cell transplantation.
['Candoni|Anna|A|', 'Lazzarotto|Davide|D|', 'Petruzzellis|Giuseppe|G|']
D000328:Adult D000970:Antineoplastic Agents D001087:Arabinonucleosides D018380:Hematopoietic Stem Cell Transplantation D006801:Humans D054218:Precursor T-Cell Lymphoblastic Leukemia-Lymphoma D012008:Recurrence D016879:Salvage Therapy
Nelarabine acute lymphoblastic leukemia lymphoblastic lymphoma neurotoxicity