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Clofarabine (Evoltra)

Find out what clofarabine is, how you have it and other important information about having clofarabine.

Clofarabine is a chemotherapy drug and is also known by its brand name Evoltra.

It is treatment for children and young people up to the age of 21 years with acute lymphoblastic leukaemia. It is used when the leukaemia has come back after at least two other treatments.

Researchers are also looking at it as a treatment for:

  • older people with acute myeloid leukaemia who can’t have high dose treatment with a stem cell transplant
  • people with myelodysplastic syndrome

How it works

Clofarabine is a type of chemotherapy drug known as an anti metabolite. Anti metabolites stop cells making DNA, which is the genetic material of the cell. Cancer cells need to make and repair DNA so that they can grow and multiply.

How you have it

You have clofarabine into your bloodstream (intravenously).

You have the treatment through a drip into your arm. A nurse puts a small tube (a cannula) into one of your veins and connects the drip to it.

You might need a central line. This is a long plastic tube that gives the drugs into a large vein, either in your chest or through a vein in your arm. It stays in while you’re having treatment, which may be for a few months.

When you have it

You have clofarabine as a drip for 2 hours each day for 5 days. You also have extra fluids through the drip to help stop the build up of uric acid. Uric acid can build up in the body when cancer cells are broken down.

After the 5 days of treatment you have a break from treatment of 2 to 6 weeks. This makes up a treatment cycle.

Once your level of blood cells goes back to normal you have the next cycle of treatment. The number of cycles of treatment you have depends on your treatment plan and how well the treatment works.

Tests during treatment

You have blood tests before starting treatment and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.

Side effects

Important information

Other medicines, foods and drink

Cancer drugs can interact with some other medicines and herbal products. Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies.

Pregnancy and contraception

This treatment might harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment and for a few months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.

Fertility

You may not be able to become pregnant or father a child after treatment with this drug. Talk to your doctor before starting treatment if you think you may want to have a baby in the future. Men may be able to store sperm before starting treatment. Women may be able to store eggs or ovarian tissue but this is rare.

Breastfeeding

Don’t breastfeed during this treatment because the drug may come through in your breast milk.

Treatment for other conditions

Always tell other doctors, nurses, pharmacists or dentists that you’re having this treatment if you need treatment for anything else, including teeth problems.

Immunisations

Don’t have immunisations with live vaccines while you’re having treatment and for at least 6 months afterwards.

In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and shingles vaccine (Zostavax).

You can:

  • have other vaccines, but they might not give you as much protection as usual
  • have the flu vaccine
  • be in contact with other people who've had live vaccines as injections

Avoid contact with people who’ve had live vaccines taken by mouth (oral vaccines). This includes the rotavirus vaccine given to babies. The virus is in the baby’s urine for up to 2 weeks and can make you ill. So, avoid changing their nappies for 2 weeks after their vaccination if possible. Or wear disposable gloves and wash your hands well afterwards.

You also need to avoid anyone who has had oral polio or typhoid vaccination recently.

More information about this treatment

For further information about this treatment go to the electronic Medicines Compendium (eMC) website.

You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.

Information and help

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About Cancer generously supported by Dangoor Education since 2010.