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    DAE Class; Rx

    Common Brand Names; Nipent, DCF, 2Deoxycoformycin

    • Antineoplastics, Antimetabolites

    Purine nucleoside antimetabolite
    Used for the treatment of hairy-cell leukemia
    Use of higher than the FDA-approved doses or use with fludarabine is not recommended due to toxicity

    Indicated for the treatment of hairy-cell leukemia.

    For the treatment of chronic lymphocytic leukemia (CLL), in combination with cyclophosphamide and rituximab.

    For stem cell transplant preparation prior to allogeneic stem cell transplantation, in combination with extracorporeal photopheresis and reduced dose total body irradiation.

    For the treatment of graft-versus-host disease (GVHD). For the treatment of corticosteroid-refractory acute graft-versus-host disease (GVHD). 

    For the treatment of advanced cutaneous T-cell lymphoma (CTCL), including mycosis fungoides and Sezary syndrome.


    Concomitant fludarabine: risk of fatal pulmonary toxicity

    Relative: active infections

    All grades of severity are listed unless otherwise indicated


    Increased creatinine (93%)

    Increased creatine phosphokinase (58%)

    Increased gamma glutamyl transferase (GGT) (45%)

    Fatigue (43%)

    Nausea (41%)

    Diarrhea (36%)

    Anemia (36%)

    Vomiting (30%)

    Increased AST/ALT (27-29%)

    Abdominal pain (28%)

    Constipation (22%)

    Rash (22%)

    Increased alkaline phosphatase (21%)

    Visual impairment (20%)

    Serous retinopathy/retinal pigment epithelial dystrophy (RPED) (20%)

    Hemorrhage (19%)

    Hyponatremia (18%)

    Pyrexia (18%)

    Dizziness (15%)

    Leukopenia (13%)

    Lymphopenia (13%)

    Neutropenia (13%)

    Peripheral edema (13%)

    Increased GGT, Grades 3 and 4 (11%)

    Hypertension (11%)

    Black Box Warnings

    The drug should be administered under the supervision of an experienced cancer chemotherapy physician in a facility equipped to diagnose and manage complications

    Do not exceed recommended doses. Nephrotoxicity, hepatotoxicity, CNS, and pulmonary toxicity occurred in phase 1 studies that used higher doses than recommended

    Do not use with concurrent fludarabine because of increased risk of pulmonary toxicity


    Epilepsy, liver dz, bone marrow depression

    Weigh risk/benefit for pts w/ infections

    Withhold if elevated SCr, renal dysfunction

    Withhold or discontinue if evidence of CNS toxicity

    Avoid pregnancy

    Pregnancy Category: D

    Lactation: not known if excreted in breast milk, do not nurse


    4 mg/m2 IV once every other week.


    4 mg/m2 IV once every other week.


    Safety and efficacy not established.


    Safety and efficacy not established.


    powder for injection

    • 10mg/vial