Neurologic Adverse Reactions

Experienced Personnel

• Should be administered under the supervision of a physician experienced in the use of cancer chemotherapeutic agents.
• Intravenous use only.

Neurologic Events

• Severe neurologic events have been reported with the use of nelarabine. These events have included altered mental states including severe somnolence, central nervous system effects including convulsions, and peripheral neuropathy ranging from numbness and paresthesias to motor weakness and paralysis.
• There have also been reports of events associated with demyelination, and ascending peripheral neuropathies similar in appearance to Guillain-Barre syndrome.
• Full recovery from these events has not always occurred with cessation of therapy.
• Close monitoring for neurologic events is strongly recommended, and the drug should be discontinued for neurologic events of NCI Common Toxicity criteria grade 2 or greater.