T-cell lymphoblastic lymphoma (T-LBL)

Active Ingredient: Nelarabine

Indication for Nelarabine

Population group: only adults (18 years old or older)

Nelarabine is indicated for the treatment of patients with T-cell lymphoblastic lymphoma (T-LBL) whose disease has not responded to or has relapsed following treatment with at least two chemotherapy regimens.

For this indication, competent medicine agencies globally authorize below treatments:

1,500 mg/m² once every 2 days

Route of admnistration


Defined daily dose

1,500 - 1,500 mg per m² of body surface area (BSA)

Dosage regimen

From 1,500 To 1,500 mg per m² of body surface area (BSA) once every 2 day(s) for 5 day(s)

Detailed description

The recommended dose of nelarabine for adults and adolescents aged 16 years and older is 1,500 mg/m² administered intravenously over two hours on days 1, 3 and 5 and repeated every 21 days.

Dose modification

Nelarabine must be discontinued at the first sign of neurological events of National Cancer Institute Common Terminology Criteria Adverse Event (NCI CTCAE) grade 2 or greater. Delaying subsequent dosing is an option for other toxicities, including haematological toxicity.

Dosage considerations

It should be administered intravenously as a two-hour infusion.

Active ingredient


Nelarabine is a pro-drug of the deoxyguanosine analogue ara-G. Accumulation of ara-GTP in leukaemic blasts allows for preferential incorporation of ara-GTP into deoxyribonucleic acid (DNA) leading to inhibition of DNA synthesis. This results in cell death. Other mechanisms may contribute to the cytotoxic effects of nelarabine. In vitro, T-cells are more sensitive than B-cells to the cytotoxic effects of nelarabine.

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