PBOX-15 and Fludarabine

'Fludarabine is licensed for the initial treatment of advanced B-cell chronic lymphocytic leukaemia (CLL) or after first-line treatment in patients with sufficient bone-marrow reserves; it is given by mouth, by intravenous injection, or by intravenous infusion. Fludarabine is well tolerated but it does cause myelosuppression, which may be cumulative. Immunosuppression is also common (see panel on cladribine and fludarabine below), and co-trimoxazole is used to prevent pneumocystis infection. Immune-mediated haemolytic anaemia, thrombocytopenia, and neutropenia are less common side-effects.

The Scottish Medicines Consortium has advised (October 2006) that fludarabine is accepted for restricted use for the treatment of B-cell chronic lymphocytic leukaemia (CLL) in patients with sufficient bone marrow reserves. First-line treatment should only be initiated in patients with advanced disease, Rai stages III/IV (Binet stage C), or Rai stages I/II (Binet stage A/B) where the patient has disease-related symptoms or evidence of progressive disease.

NICE guidance
Fludarabine monotherapy for the first-line treatment of chronic lymphocytic leukaemia (February 2007)

Fludarabine monotherapy, is not recommended for the first-line treatment of chronic lymphocytic leukaemia.'

BNF

http://www.pnptherapeutics.com/technology-how.html
http://www.pnptherapeutics.com/technology-how.html

PBOX-15: anti-leukaemia drug under development
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http://www.springerlink.com/content/rq5j447430578094/fulltext.html

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