Chemotherapy with fludarabine is usually used for the treatment of patients suffering from CLL(chronic lymphocytic leukemia). Before you and your doctor plan to start with fludarabine chemotherapy, you should know a few facts about this medicine. The following article gives a general idea about chemotherapy this drug. For more information you should contact your oncologist and have your doubts clarified. This drug is a clear liquid and is also present in the form of tablets. It is usually used in combination with other drugs.

Use of Fludara

1. Fludara or fludarabine is used in the treatment of chronic CLL. It is also used to treat cases where CLL has relapsed even after giving prior treatment for the cancer.
2. It is used to treat cases of acute leukemia and non-Hodgkin’s lymphoma
3. It is used to treat AML or acute myelogenous leukemia
4. The doctors use this drug to treat some other types of conditions
5. The doctors use it in combination with other drugs to prepare a patient for a bone marrow transplant

Doctors usually give this drug in combination with mitoxantrone, and dexamethasone (FMD regimen) or it can be used in combination with cyclophosphamide (FC regimen). Another regimen involving this drug is FAD (fludarabine, mitoxantrone, and dexamethasone), this regimen is used to treat low grade lymphomas. These days there are researches of fludarabine being used in combination with rituximab. Your oncologist will be the best person to decide whether this drug should to given alone or in combination with other drugs.

How it works

Fludara (or fludarabine) is a chemotherapy drug that prevents the growth of tumor cells by not letting grow normally. It is usually used to treat the patients in the induction stage where the primary aim of the doctors is remission when a patient is undergoing leukemia chemotherapy. Researchers suggest that this drug is quite effective to bring about remission in the patients. Although this drug has given good results in the past, the combination of drugs used with fludarabine depends on many factors, like the age of the patient, the type of cancer, the stage of cancer. You can consult your oncologist to ask about your Fludarabine regimen.

Administration of Fludarabine

Fludarabine is usually given intravenously to the patients. It can be given to the patients in any of the following methods:

• It can be given through a fine catheter that is inserted at the back of your hand or into PICC line directly. (This vein is located in the crook of the arm).
• It can be injected into the saline drip of the patient.
• It can be directly inserted into the central line. (A central line is a long hollow tube that is made out of rubber. It is inserted under the skin into a vein near the chest. This tube can be closed with a cap after the patient has been given the drug).
• As Fludarabine is available in the form of tablets, it can also be consumed orally.

The chemotherapy treatment with fludarabine involves several cycles and may last several months. Usually these cycles are repeated according to the regimen decided at the beginning of the treatment. You can discuss this regimen with your oncologist before starting the treatment. Many patients do not ask questions to their doctors and are quite unprepared for what they should expect during the course of the treatment. If you have any allergic reactions to any kind of drugs then report it to your doctor before you start your treatment.

Side Effects

As this drug is used to destroy the cancer cells in the blood, it significantly reduces the blood count levels, thereby making it very prone to infections like pneumonia. Patients undergoing treatment with this drug are usually given antimicrobial medication to prevent pneumonia.

The patients can also become prone to a rare condition called transfusion-associated graft versus host disease. This is a rare complication of blood transfusion that can be fatal. In this disease, the recipient’s (patient’s) immune system identifies the donor lymphocytes as foreign and destroys them. So the doctors usually recommend that the patients who have received treatment with fludarabine should be given irradiated blood.

Another complication that can arise in patients treated with fludarabine previously, is that it is difficult to increase the production of peripheral stem cells in their body.

Fludarabine also causes anemia, neutropenia and thrombocytopenia. So when this drug is given, a patient’s blood count is constantly monitored. Some patients might need to have blood transfusion to boost the count of the blood cells.

Researches indicate that in some cases fludarabine can cause severe autoimmune hemolytic anemia. In this condition, the antibodies attack a person’s own red blood cells (RBC).

There are several other side effects of chemotherapy treatment with fludarabine like nausea, hair loss, fatigue, diarrhea, sore mouth, irritation of bladder, low immunity, weight loss and other symptoms.

Although fludarabine chemotherapy was initially used for treating CLL, it has been found to be effective other types of leukemias. Researchers are trying to use it in combination with other drugs to increase its effectiveness. There has been a lot of research since it was first discovered in 1968 in Southern Research Institute.