Purpose/objectives: To review clinical applications and nursing care activities for patients receiving cladribine, a synthetic antineoplastic agent used to treat lymphoid malignancies.
Data sources: Clinical trial data, published articles, reports from oncology nurses, and personal observations.
Data synthesis: Cladribine has shown response rates of nearly 90% in patients with hairy cell leukemia after a single, seven-day continuous infusion. Toxicities generally are mild, predictable, and rapidly reversible after therapy is discontinued.
Conclusions: Currently, cladribine primarily is used in hairy cell leukemia therapy. Clinical trials of cladribine in treating other hematologic malignancies, primarily chronic lymphocytic leukemia and non-Hodgkin's lymphoma, have demonstrated encouraging results.
Implications for nursing practice: Nursing care for patients who receive cladribine involves management of side effects, which commonly include myelosuppression and fever, and monitoring of hemoglobin, platelet levels, and body temperature. Fever develops in most patients receiving cladribine but is usually transient and easily treated with acetaminophen. Infection as a cause of fever must be ruled out, especially in patients with neutropenia.