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1.
Environ Mol Mutagen ; 61(9): 922-927, 2020 11.
Article in English | MEDLINE | ID: mdl-32567744

ABSTRACT

The aim of the present in vivo study was to determine the kinetics of the genotoxic and cytotoxic activities of cladribine and clofarabine in mouse normoblasts using flow cytometry. Mice in groups of five were treated with cladribine or clofarabine. Blood samples were obtained from the mouse tails before treatment and every 8 hr posttreatment for 72 hr. These samples were cytometrically scored for micronucleated reticulocytes (RETs), and the percentage of RETs was determined. The results showed that clofarabine and cladribine have early cytotoxic effects that are related to the genotoxic effects reported in previous studies; the drugs have both complex long-lasting genotoxic and cytotoxic kinetic activity, with similar profiles that suggest a relationship between the genotoxic and cytotoxic parameters. The initial genotoxkinetics timing of clofarabine is equivalent to those of difluorodeoxycytidine, likely because both agents inhibit DNA polymerase. Clofarabine shows a higher genotoxic and cytotoxic efficiency than cladribine, in agreement with previous results.


Subject(s)
Antineoplastic Agents/toxicity , Cladribine/toxicity , Clofarabine/toxicity , Micronuclei, Chromosome-Defective/drug effects , Reticulocytes/drug effects , Animals , Antineoplastic Agents/blood , Cladribine/blood , Clofarabine/blood , Kinetics , Male , Mice , Mice, Inbred ICR , Micronucleus Tests , Reticulocytes/metabolism
2.
Clin Pharmacokinet ; 58(3): 283-297, 2019 03.
Article in English | MEDLINE | ID: mdl-29987837

ABSTRACT

Cladribine Tablets (MAVENCLAD®) are used to treat relapsing multiple sclerosis (MS). The recommended dose is 3.5 mg/kg, consisting of 2 annual courses, each comprising 2 treatment weeks 1 month apart. We reviewed the clinical pharmacology of Cladribine Tablets in patients with MS, including pharmacokinetic and pharmacometric data. Cladribine Tablets are rapidly absorbed, with a median time to reach maximum concentration (Tmax) of 0.5 h (range 0.5-1.5 h) in fasted patients. When administered with food, absorption is delayed (median Tmax 1.5 h, range 1-3 h), and maximum concentration (Cmax) is reduced by 29% (based on geometric mean). Area under the concentration-time curve (AUC) is essentially unchanged. Oral bioavailability of cladribine is approximately 40%, pharmacokinetics are linear and time-independent, and volume of distribution is 480-490 L. Plasma protein binding is 20%, independent of cladribine plasma concentration. Cladribine is rapidly distributed to lymphocytes and retained (either as parent drug or its phosphorylated metabolites), resulting in approximately 30- to 40-fold intracellular accumulation versus extracellular concentrations as early as 1 h after cladribine exposure. Cytochrome P450-mediated biotransformation of cladribine is of minor importance. Cladribine elimination is equally dependent on renal and non-renal routes. In vitro studies indicate that cladribine efflux is minimally P-glycoprotein (P-gp)-related, and clinically relevant interactions with P-gp inhibitors are not expected. Cladribine distribution across membranes is primarily facilitated by equilibrative nucleoside transporter (ENT) 1, concentrative nucleoside transporter (CNT) 3 and breast cancer resistance protein (BCRP), and there is no evidence of any cladribine-related effect on heart rate, atrioventricular conduction or cardiac repolarisation (QTc interval prolongation). Cladribine Tablets are associated with targeted lymphocyte reduction and durable efficacy, with the exposure-effect relationship showing the recommended dose is appropriate in reducing relapse risk.


Subject(s)
Cladribine/pharmacokinetics , Immunosuppressive Agents/pharmacokinetics , Multiple Sclerosis, Relapsing-Remitting/drug therapy , ATP Binding Cassette Transporter, Subfamily B, Member 1/antagonists & inhibitors , ATP Binding Cassette Transporter, Subfamily B, Member 1/drug effects , ATP Binding Cassette Transporter, Subfamily B, Member 1/metabolism , ATP Binding Cassette Transporter, Subfamily G, Member 2/drug effects , ATP Binding Cassette Transporter, Subfamily G, Member 2/metabolism , Administration, Oral , Adult , Aged , Biological Availability , Cladribine/administration & dosage , Cladribine/blood , Cladribine/therapeutic use , Cytochrome P-450 Enzyme System/metabolism , Equilibrative Nucleoside Transporter 1/drug effects , Equilibrative Nucleoside Transporter 1/metabolism , Female , Humans , Immunosuppressive Agents/administration & dosage , Immunosuppressive Agents/blood , Immunosuppressive Agents/therapeutic use , Lymphocytes/drug effects , Lymphocytes/metabolism , Male , Membrane Transport Proteins/drug effects , Membrane Transport Proteins/metabolism , Middle Aged , Neoplasm Proteins/drug effects , Neoplasm Proteins/metabolism , Pharmacology, Clinical , Protein Binding/drug effects
3.
Bioorg Med Chem ; 23(13): 3287-96, 2015 Jul 01.
Article in English | MEDLINE | ID: mdl-25960323

ABSTRACT

Phospholipid derivatives of anticancer nucleosides cladribine and fludarabine (F-ara-A) bearing 1,2- and 1,3-diacylglycerol moieties have been prepared by the H-phosphonate approach using 1,1,3,3-tetraisopropyldisiloxane-1,3-diyl protecting group for cladribine and a combination of tert-butyldimethylsilyl and levulinyl protecting groups for 2-fluoroadenine nucleosides. The synthesized conjugates exhibited lower in vitro antiproliferative activity against human tumor cell lines in comparison with the same concentrations of the parent cladribine and fludarabine phosphate. In the course of biokinetic study, it was found that intragastric administration of phospholipid F-ara-A derivatives to Wistar rats and ICR outbred male mice led to a slow release of F-ara-A into the bloodstream, a smooth increase in nucleoside concentration, and prolonged serum circulation of liberated nucleoside. The oral bioavailability of F-ara-A from 1,2-dimyristoylglycerophosphate derivative 29 was similar to its oral bioavailability from fludarabine phosphate.


Subject(s)
Antimetabolites, Antineoplastic/pharmacokinetics , Cladribine/pharmacokinetics , Diglycerides/chemistry , Phospholipids/chemistry , Prodrugs , Vidarabine/analogs & derivatives , Animals , Antimetabolites, Antineoplastic/blood , Antimetabolites, Antineoplastic/chemical synthesis , Biological Availability , Biotransformation , Cell Line, Tumor , Cell Survival/drug effects , Cladribine/analogs & derivatives , Cladribine/blood , Cladribine/chemical synthesis , Diglycerides/metabolism , Humans , Male , Mice , Mice, Inbred ICR , Molecular Structure , Organophosphonates/chemistry , Phospholipids/metabolism , Rats , Rats, Wistar , Vidarabine/blood , Vidarabine/chemical synthesis , Vidarabine/pharmacokinetics
4.
Xenobiotica ; 43(12): 1084-94, 2013 Dec.
Article in English | MEDLINE | ID: mdl-23627543

ABSTRACT

New insight into the in vitro and in vivo metabolism of Cladribine (2-chloro-2'-deoxyadenosine, [2-CdA]) are presented. Following incubation of [(14)C]-2-CdA in mouse, rat, rabbit, dog, monkey and human hepatocyte cultures, variable turnover was observed with oxidations and direct glucuronidation pathways. The oxidative cleavage to 2-chloroadenine (2-CA, M1) was only observed in rabbit and rat. Following incubation of [(14)C]-2-CdA in whole blood from mouse, monkey and human, a significant turnover was observed. The main metabolites in monkey and human were 2-chlorodeoxyinosine (M11, 16% of total radioactivity) and 2-chlorodeoxyinosine (M12, 43%). In mouse, 2-CA was the major metabolite (2-CA; M1, 73%). After single intravenous and oral administration of [(14)C]-2-CdA to mice, 2-chlorodeoxyinosine (M11) was confirmed in plasma, while 2-chlorohypoxanthine (M12) and 2-CA (M1) were found in urine. Overall, the use of [(14)C]-2-CdA both in vitro (incubations in mouse, monkey and human whole blood) and in vivo (mouse) has confirmed the existence of an additional metabolism pathway leading to the formation of 2-chlorodeoxyinosine (M11) and 2-chlorohypoxanthine (M12). Formation of these two metabolites demonstrates that Cladribine as free form is not fully resistant to adenosine deaminase as suggested earlier, an enzyme involved in its mode of action.


Subject(s)
Cladribine/metabolism , Administration, Intravenous , Administration, Oral , Animals , Chromatography, High Pressure Liquid , Cladribine/blood , Cladribine/chemistry , Cladribine/urine , Dogs , Feces , Haplorhini , Hepatocytes/metabolism , Humans , Mass Spectrometry , Metabolic Networks and Pathways , Metabolome , Mice , Rabbits , Rats
5.
Drug Metabol Drug Interact ; 23(3-4): 291-8, 2008.
Article in English | MEDLINE | ID: mdl-19326772

ABSTRACT

Male Sprague Dawley rats (n = 6-8 per group) weighing from 300-450 g were used for the study. Each rat received a single dose of cladribine (CdA) by ia (1 mg/kg) or s.c. (2 mg/kg) injection. Pharmacokinetic data were calculated by standard procedures assuming a 2-compartment open model following i.v. bolus using WinNonLin and Rstrips, and differences between the two modes of injections were considered significance when p < 0.05. The results showed that plasma concentrations of CdA decreased rapidly following a biphasic decline after both ia and s.c. administrations. The AUC and t1/2 beta after a single 1 mg/kg ia and 2 mg/kg s.c. injection of CdA were 0.66 +/- 0.34 vs 1.2 +/- 0.3 microg x h/ml and 3.5 +/- 2.1 vs 4.5 +/- 2.2 h, respectively (p > 0.05). The mean absolute bioavailability following the s.c. injection was close to 90%. The inter-subject variability of plasma concentrations of CdA was 35% and 150% following sc and ia injections, respectively. It is concluded that the rat is a reasonably good animal model to study the pharmacokinetics of CdA in plasma, and that sc injection may produce more favourable pharmacokinetic profiles than ia injection following a single dose.


Subject(s)
Antineoplastic Agents/blood , Cladribine/blood , Animals , Antineoplastic Agents/administration & dosage , Biological Availability , Chromatography, High Pressure Liquid/methods , Cladribine/administration & dosage , Injections, Intra-Arterial , Injections, Subcutaneous , Male , Models, Animal , Rats , Rats, Sprague-Dawley
6.
J Pharm Pharm Sci ; 10(2): 231-6, 2007.
Article in English | MEDLINE | ID: mdl-17706181

ABSTRACT

PURPOSE: To develop and validate a sensitive and specific HPLC assay for cladribine (CdA) in plasma for pharmacokinetic studies in rats. METHODS: CdA and the internal standard AZT were purchased from Sigma-Aldrich Chem. The HPLC system consisted of a Shimadzu LC-9A pump, a 3 im, 250 x 2.0 mm I.D. high speed C18 column (Jupitertrade mark), preceded by a 5 im 4 4 mm I.D. C18 guard column (Licrocarttrade mark), an Agilent Model 1050 UV-VIS detector and a 3395 Integrator. The mobile phase was made up of 0.01M KH2PO4 (pH 5): methanol: acetonitrile 90:5:5). The system was operated at ambient temperature with a flow rate of 0.3 mL/min, and UV wavelength at 265 nm, and an operating pressure of ca. 1.56 kpsi. Extraction of cladribine and AZT from plasma was achieved by solid phase extraction using 100 mg/mL C18 SPE columns Extra-septrade mark). The assay was validated for sensitivity, precision, specificity and application for pharmacokinetic study in rats. RESULTS: Under these conditions, the average retention times of CdA and AZT were 13.5 and 21 min, respectively, and recoveries were between 80 - 95%. Standard curve constructed from plasma standards was linear from 0.1 ug/mL to 1 ug/mL with regression coefficient (r2) 0.99 or greater. Sensitivity assessed by on column injection was < 1 ng. Using a 50-uL plasma sample size, the mean intra assay variations 0.1 ug/mL were 7%, and inter assay variations over a period of 3 months for 5 separate batches were less than 20%. The assay was used to study a single dose pharmacokinetic study of CdA in rats after a 2 mg/kg subcutaneous injection. CONCLUSION: The described HPLC assay has adequate sensitivity and specificity to study pharmacokinetics of CdA in rats, and could be adapted also to clinical pharmacokinetic studies.


Subject(s)
Antineoplastic Agents/blood , Cladribine/blood , Animals , Antineoplastic Agents/pharmacokinetics , Chromatography, High Pressure Liquid , Cladribine/pharmacokinetics , Male , Rats , Rats, Sprague-Dawley , Reproducibility of Results , Solid Phase Extraction
7.
J Pharm Biomed Anal ; 44(2): 492-7, 2007 Jun 28.
Article in English | MEDLINE | ID: mdl-17368998

ABSTRACT

Several fast high performance liquid chromatography/atmospheric pressure ionization/tandem mass spectrometric (HPLC-API/MS/MS) methods were evaluated for the simultaneous determination of cladribine and clofarabine in mouse plasma samples. The chemical separation for analytes under reversed-phase conditions were achieved by using either ultra-performance liquid chromatography (UPLC) or micro-column HPLC coupled to either a quadrupole linear ion trap mass spectrometer (QTrap MS) or a triple quadrupole mass spectrometer. Atmospheric pressure chemical ionization (APCI) or atmospheric pressure photoionization (APPI) interfaces in the positive mode were employed prior to mass spectrometric detection. The effects of various dopant solvents on the APPI sensitivities of analytes and the internal standard were investigated. The matrix ionization suppression potential for the test compounds in plasma samples on fast HPLC-MS/MS methods was examined by a post-column infusion technique. In this work, these proposed approaches were successfully employed to determine the concentrations of cladribine and clofarabine in mouse plasma in the low ng/ml region. The mouse plasma levels of all analytes obtained by these fast HPLC-MS/MS methods were compared and found to be well correlated in terms of analytical accuracy.


Subject(s)
Adenine Nucleotides/blood , Arabinonucleosides/blood , Cladribine/blood , Immunosuppressive Agents/blood , Animals , Antifungal Agents/blood , Chromatography, High Pressure Liquid , Clofarabine , Indicators and Reagents , Ketoconazole/blood , Mass Spectrometry , Mice , Reference Standards , Reproducibility of Results
8.
Rapid Commun Mass Spectrom ; 19(24): 3673-80, 2005.
Article in English | MEDLINE | ID: mdl-16287039

ABSTRACT

Fludarabine and cyclophosphamide are anticancer agents mainly used in the treatment of hematologic malignancies. We have developed and validated an assay using high-performance liquid chromatography (HPLC) coupled with electrospray ionization tandem mass spectrometry for the quantification of fludarabine in combination with cyclophosphamide in human heparin and human EDTA plasma. Sample pre-treatment consisted of a protein precipitation with cold acetonitrile (-20 degrees C) using 250 microL of plasma. Separation was performed on an Extend C18 column (150 x 2.1 mm i.d.; 5 microm) with a stepwise gradient using 1 mM ammonia solution and acetonitrile at a flow rate of 400 microL/min. The analytical run time was 12 min. The triple quadrupole mass spectrometer was operated in the positive ion mode and multiple reaction monitoring was used for drug quantification. The method was validated over a concentration range of 1 to 100 ng/mL for fludarabine and cyclophosphamide in human heparin and human EDTA plasma. The coefficients of variation were <13.9% for inter- and intra-day precisions. Mean accuracies were also within the designated limits (+/-15%). The analytes were stable in plasma, processed extracts and in stock solution under all relevant conditions.


Subject(s)
Antineoplastic Agents/blood , Chromatography, High Pressure Liquid/methods , Cyclophosphamide/blood , Spectrometry, Mass, Electrospray Ionization/methods , Vidarabine/analogs & derivatives , Cladribine/blood , Cyclophosphamide/analogs & derivatives , Humans , Molecular Structure , Reproducibility of Results , Sensitivity and Specificity , Vidarabine/blood
9.
BMC Pharmacol ; 5: 4, 2005 Mar 09.
Article in English | MEDLINE | ID: mdl-15757511

ABSTRACT

BACKGROUND: The nucleoside analog cladribine is used for the treatment of a variety of indolent B- and T-cell lymphoid malignancies. The primary aim of the study was to evaluate the population distribution of pharmacokinetic parameters in patients undergoing treatment with cladribine and to detect the influence of different covariates on the pharmacokinetic parameters. METHODS: This pharmacokinetic study presents the results of a retrospective population pharmacokinetic analysis based on pooled data from 161 patients, who were given cladribine in different administration routes in various dosing regimens. The plasma concentrations of cladribine were determined by reversed-phase high-performance liquid chromatography using a solid phase extraction with a limit of quantitation of 1 nM using 1 mL of plasma. RESULTS: A three compartment structural model best described the disposition of cladribine. Clearance was found to be 39.3 L/hour, with a large interindividual variability. The half-life for the terminal phase was 16 hours. Bioavailability was 100% and 35% for subcutaneous and oral administration, respectively, with low interindividual variability. None of the investigated covariates were found to be correlated with the pharmacokinetic parameters. CONCLUSION: As interindividual variability in apparent clearance after oral administration was not significantly higher compared to that following infusion, cladribine could be administered orally instead of intravenously if compensated for its lower bioavailability. Individualized dosing on basis of body surface area or weight does not represent an improvement in this study as compared to administering a fixed dose to all patients.


Subject(s)
Antineoplastic Agents/pharmacokinetics , Cladribine/pharmacokinetics , Administration, Oral , Adult , Aged , Aged, 80 and over , Antineoplastic Agents/administration & dosage , Antineoplastic Agents/blood , Area Under Curve , Biological Availability , Cladribine/administration & dosage , Cladribine/blood , Female , Humans , Infusions, Intravenous , Intestinal Absorption , Male , Metabolic Clearance Rate , Middle Aged , Multicenter Studies as Topic , Retrospective Studies
10.
J Pharm Biomed Anal ; 17(1): 45-51, 1998 May.
Article in English | MEDLINE | ID: mdl-9608425

ABSTRACT

A sensitive and specific assay based on combined liquid chromatography mass spectrometry (LCMS) has been developed and validated for the quantification of 2-chlorodeoxyadenosine (cladribine, 2-CdA) in human plasma. Sample preparation consisted of an extraction with ethyl acetate under basic conditions. The organic solvent was evaporated and the residue re-dissolved for analysis. The extracts were chromatographed on a base deactivated C-8 column interfaced via the heated nebulizer probe to a corona discharge chemical ionization source. The mass spectrometer was operated in the positive ion tandem mode. Typical retention times were 1.5 and 2.0 min for 2-CdA and a fluorinated analog internal standard (IS), respectively. The standard curve was linear from 0.1 to 20 ng ml-1 using a 1.0 ml sample volume. The resulting chromatograms produced sharp peaks for 2-CdA and the IS and showed no endogenous peaks from blank plasma. Peak area ratios of 2-CdA to IS were used for standard curve regression analysis. This assay procedure gave interday mean accuracy results for the standards and quality controls that were within 4.9% of target concentrations and interday precision results (RSDs) that were less than 5.3%.


Subject(s)
Antineoplastic Agents/blood , Chromatography, High Pressure Liquid/methods , Cladribine/blood , Immunosuppressive Agents/blood , Mass Spectrometry/methods , Humans , Reference Standards , Reproducibility of Results , Sensitivity and Specificity
11.
Clin Cancer Res ; 4(3): 653-8, 1998 Mar.
Article in English | MEDLINE | ID: mdl-9533533

ABSTRACT

The pharmacokinetic parameters of cladribine (CdA) in patient plasma and its intracellular nucleotides CdA 5'-monophosphate (CdAMP) and CdA 5'-triphosphate (CdATP) were delineated in circulating leukemia cells in 17 patients with chronic lymphocytic leukemia, after the last dose intake and up to 72 h thereafter. Patients were treated with 10 mg/m2 CdA p.o. on 3 consecutive days. A novel and specific ion-pair liquid chromatographic method, which separates the intracellular CdA nucleotides, was used. The area under the concentration versus time curve (AUC) of CdAMP in leukemia cells was generally higher (median, 47 micromol/liter x h) than the AUC of CdATP (median, 22 micromol/liter x h); however, in some patients (3 of 17), the reverse relationship was seen. The median ratio between the AUC values for CdATP and CdAMP was 0.60 (95% confidence interval, 0.4-1.0). The median half-life (t(1/2)) of CdAMP was 15 h, and that of CdATP was 10 h. The median terminal t(1/2) of CdA in plasma was 21 h. A significant correlation was found between the maximum plasma CdA and cellular CdAMP concentrations (r = 0.56, P = 0.02). There was no correlation between the AUC values of cellular CdAMP and CdATP (r = 0.224, P = 0.55). No correlation was found between deoxycytidine kinase activity and intracellular pharmacokinetic parameters of CdAMP or CdATP. The response to treatment was not significantly related to intracellular concentration of CdAMP or active metabolite CdATP. There is great heterogeneity among patients in terms of AUC and t(1/2) of CdAMP and CdATP. Furthermore, the results emphasize the differences between the pharmacokinetics of plasma CdA and those of the metabolites in circulating leukemic cells.


Subject(s)
Adenosine Monophosphate/analogs & derivatives , Adenosine Triphosphate/analogs & derivatives , Antineoplastic Agents/pharmacokinetics , Cladribine/analogs & derivatives , Cladribine/pharmacokinetics , Leukemia, Lymphocytic, Chronic, B-Cell/blood , Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy , Adenosine Monophosphate/blood , Adenosine Triphosphate/blood , Administration, Oral , Aged , Aged, 80 and over , Antineoplastic Agents/blood , Antineoplastic Agents/therapeutic use , Cladribine/blood , Cladribine/therapeutic use , Drug Administration Schedule , Female , Humans , Male , Metabolic Clearance Rate , Middle Aged , Regression Analysis
12.
Adv Exp Med Biol ; 431: 693-7, 1998.
Article in English | MEDLINE | ID: mdl-9598154

ABSTRACT

Seventeen patients with CLL were treated with oral 2-chloro-2'-deoxyadenosine (cladribine, CdA, 10 mg/m2) on 3 consecutive days and the pharmacokinetic parameters of CdA in patient plasma and its intracellular nucleotides (CdAMP, CdATP) in circulating leukemic cells were studied after the last dose intake and up to 72 h thereafter. The median terminal half life (t1/2) of CdA in plasma was 21.1 h and the area under the curve (AUC) was median 1.2 microMh. The median t1/2 was 14.6 h for CdAMP and 9.7 h for CdATP. The AUC of CdATP in leukemic cells is lower than the AUC of CdAMP (median ratio 0.60). There was no correlation between cellular CdATP and plasma CdA concentrations or dCK activity. The clinical response was related to higher Cmax values for plasma CdA (p = 0.05) and higher products of dCK activity and CdA Cmax of plasma (p = 0.02). The activity of dCK alone was not related to the clinical outcome in this patient group. The results suggest that further steps in the mechanism of action of CdA beyond its bioactivation may be more important, e.g. the extent of DNA fragmentation or the ability of the leukemic cell to go into apoptosis, than the concentration of CdA nucleotides alone.


Subject(s)
Adenosine Triphosphate/analogs & derivatives , Antineoplastic Agents/therapeutic use , Cladribine/analogs & derivatives , Cladribine/therapeutic use , Deoxycytidine Kinase/metabolism , Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy , Adenine Nucleotides/blood , Adenosine Triphosphate/blood , Antineoplastic Agents/blood , Antineoplastic Agents/pharmacokinetics , Cladribine/blood , Cladribine/pharmacokinetics , Female , Half-Life , Humans , Kinetics , Leukemia, Lymphocytic, Chronic, B-Cell/blood , Leukemia, Lymphocytic, Chronic, B-Cell/enzymology , Leukocytes, Mononuclear/metabolism , Male , Treatment Outcome
13.
Eur Surg Res ; 30(1): 61-8, 1998.
Article in English | MEDLINE | ID: mdl-9493696

ABSTRACT

The purine analogue 2-chlorodeoxyadenosine (2-CDA) has been shown to possess synergistic immunosuppressive properties when given together with cyclosporin (CSA) in a rat small bowel transplant model. The present study investigated the immunosuppressive potency of 2-CDA alone and in combination after liver or heart transplantation in a fully allogeneic rat model with 5 animals in each group. Immunosuppression was provided with CSA 10 mg/kg body weight (BW)/day orally or 2-CDA 0.1 mg/kg/BW day intravenously or both compounds together in the dosages mentioned. Animals were sacrificed on day 10 following transplantation, and graft histology was assessed. In addition, cardiac graft function was evaluated by palpation immediately prior to sacrificing the animal. CSA given alone was able to mitigate but not prevent rejection. 2-CDA alone did not exhibit any detectable immunosuppressive effect. When CSA was combined with 2-CDA, no rejection was seen in 80% of the liver allografts and in 60% of heart allografts, and only mild rejection was observed in the remaining animals. All hearts of the combined treatment group, however, beat strongly. From these findings it is concluded that 2-CDA alone has no, but together with CSA a strong immunosuppressive effect in preventing solid organ allograft rejection.


Subject(s)
Cladribine/administration & dosage , Cyclosporine/administration & dosage , Graft Rejection/prevention & control , Heart Transplantation , Immunosuppressive Agents/administration & dosage , Liver Transplantation , Animals , Cladribine/blood , Cyclosporine/blood , Drug Therapy, Combination , Rats , Rats, Inbred BN , Rats, Inbred Lew , Transplantation, Homologous
14.
Anticancer Drugs ; 8(5): 445-53, 1997 Jun.
Article in English | MEDLINE | ID: mdl-9215606

ABSTRACT

Cladribine (2-chloro-2'-deoxyadenosine, CdA) is a purine nucleoside analog with activity against lymphoproliferative and autoimmune disorders. 2-Chloro-2'-arabino-fluoro-2'-deoxyadenosine (CAFdA), a derivative of CdA with better acid stability, shows a similar in vitro spectrum of activity as CdA. 2-Chloroadenine (CAde) is the major catabolite of both CdA and CAFdA. We have developed a high performance liquid chromatography method to measure CdA, CAFdA and their metabolite CAde in plasma. This method employees an internal standard, chloroadenosine (CAdo), and a C8 solid-phase extraction to isolate and concentrate the substances. Chromatographic separation was achieved using a C8 reverse-phase column, with UV detection at 265 nm, which gives a limit of detection of 1 nmol/l for all substances. The method was reproducible with intra- and inter-assay coefficients of variations below 6% at 50 nmol/l and at 5 nmol/l below 23%. The average recoveries of CdA, CAde, CAFdA and the internal standard were higher than 70%. Stability studies of authentic patient samples show that samples containing CdA should be kept in a refrigerator or on ice to prevent degradation. Plasma containing CAde should not be kept at -20 degrees C for longer than 10 weeks before analysis. CdA and CAFdA remain almost stable during storage at -20 degrees C for 12 weeks.


Subject(s)
Adenine/analogs & derivatives , Antineoplastic Agents/blood , Arabinonucleosides/blood , Cladribine/blood , Adenine/blood , Adenine Nucleotides , Aged , Chromatography, High Pressure Liquid , Clofarabine , Female , Humans , Male , Middle Aged , Reproducibility of Results , Spectrophotometry, Ultraviolet
15.
Pharmazie ; 50(7): 459-60, 1995 Jul.
Article in English | MEDLINE | ID: mdl-7675888

ABSTRACT

A quantitative fluorescence assay for 2-chloro-2'-deoxyadenosine (cladribine, leustatin, 2-CdA) in human plasma is described. The drug was isolated from plasma by ethyl acetate extraction and derivatized by a two-step procedure in which 2'-deoxyisoguanosine (2'-diG) was first prepared by UV irradiation of 2-CdA and was then treated with chloroacetaldehyde to form the fluorescent derivative, 1,N6-etheno-2'-deoxyisoguanosine. Fluorescence intensity of the solutions was measured using an excitation wavelength of 275 nm and emission of 397 nm. The analytical measuring range of the method extends from about 1 microgram/l to at least 100 micrograms/l.


Subject(s)
Cladribine/blood , Acetaldehyde/analogs & derivatives , Acetaldehyde/chemistry , Chromatography, High Pressure Liquid , Cladribine/chemistry , Humans , Magnetic Resonance Spectroscopy , Photochemistry , Spectrometry, Fluorescence , Spectrophotometry, Ultraviolet
16.
Eur J Drug Metab Pharmacokinet ; 20(3): 225-32, 1995.
Article in English | MEDLINE | ID: mdl-8751045

ABSTRACT

2-Chloro-2'-deoxyadenosine (CdA), a newly developed anticancer drug, has been tested in phase II trials in the treatment of lymphoproliferative disorders. 2-Chloro-2'-arabino-fluoro-2'-deoxyadenosine (CAFdA), an acid stable derivative of CdA with promising anti-lymphoproliferative activity, has been suggested as a potentially effective oral drug. In the present study, we investigated the metabolism of CdA and CAFdA in isolated perfused rat liver. The liver was recycled with a perfusate containing CdA or CAFdA (2-200 micrograms/ml) for 3.5 h. The elimination half-lives were concentration-dependent for both CdA and CAFdA. The elimination rate of CAFdA was slower than that of CdA, suggesting that CAFdA is more stable than CdA against deglycosylation by hepatic enzymes. The amount of 2-chloroadenine (CAde), the major metabolite of CdA and CAFdA, increased proportionally with time and dose. The first passage effect was approximately 50% both for CdA and CAFdA. Less than 1% of CdA and CAFdA were recovered as intact drug in the bile during the experiment and less than 1% of CdA and 0.1% of CAFdA were found as CAde in the bile, respectively. The structural identity of metabolites present in the perfusates was verified utilizing electrospray ionization mass spectrometry.


Subject(s)
Antimetabolites, Antineoplastic/metabolism , Antineoplastic Agents/metabolism , Arabinonucleosides/metabolism , Cladribine/metabolism , Liver/metabolism , Adenine Nucleotides , Animals , Antimetabolites, Antineoplastic/blood , Antineoplastic Agents/blood , Arabinonucleosides/blood , Bile/metabolism , Cladribine/blood , Clofarabine , Male , Rats , Rats, Sprague-Dawley
17.
J Pharm Biomed Anal ; 13(4-5): 661-5, 1995 Apr.
Article in English | MEDLINE | ID: mdl-9696584

ABSTRACT

2-Chloro-2'-deoxyadenosine (CdA) is a new drug for the treatment of hairy cell leukemia and other lymphoproliferative diseases. It is generally administered as a continuous intravenous infusion during 5-7 days. The oral bioavailability is only 50%. The bioavailability after rectal administration was investigated in two patients with chronic lymphocytic leukemia. Five milligrams per square metre was given i.v. as a 2-h infusion and 24 h later the same dose was administered rectally in a gel formulation. The mean bioavailability was only 21% due to deglycosylation of CdA to 2-chloroadenine (CAde). To further elucidate the factors which are important for the rectal availability of CdA, the in vitro stability of CdA in bacterial cultures was tested. Clostridium perfringens and Escherichia coli as well as whole feces rapidly deglycosylated CdA to CAde while Bacteroides fragilis, Enterococcus faecalis as well as saliva only degraded CdA slowly or not at all. It is concluded that, due to bacterial degradation, rectal administration of CdA has no advantage over oral administration.


Subject(s)
Bacteria/metabolism , Cladribine/pharmacokinetics , Administration, Rectal , Aged , Biological Availability , Biotransformation , Cladribine/blood , Cladribine/metabolism , Feces/chemistry , Humans , Leukemia, Lymphocytic, Chronic, B-Cell/metabolism , Male , Middle Aged , Saliva/metabolism
18.
Br J Haematol ; 87(4): 715-8, 1994 Aug.
Article in English | MEDLINE | ID: mdl-7986711

ABSTRACT

2-Chlorodeoxyadenosine (CdA) is an antileukaemic agent used in treatment of hairy cell leukaemia (HCL) and chronic lymphocytic leukaemia of B- and T-cell type (B-CLL and T-CLL). The aim of this study was to elucidate the interpatient variability of CdA phosphorylation and its relation to response to CdA treatment. In extracts of peripheral blood mononuclear cells of patients with B-CLL (n = 39), CdA phosphorylation was significantly higher than in HCL (n = 19) when calculated per protein (391 +/- 155 pmol CdA phosphorylated/mg protein/min versus 288 +/- 166 pmol/mg/min, P < 0.001), but was the same when calculated per cell (12 +/- 5.9 pmol/10(6) cells/min versus 14 +/- 5.9 pmol/10(6) cells/min) due to a larger cell volume in HCL. In T-CLL (n = 6), CdA phosphorylation was significantly lower than in B-CLL, both when calculated per protein (128 +/- 68 pmol/mg/min, P < 0.001) or per cell (5.7 +/- 2.7 pmol/10(6) cells/min, P < 0.05). This low CdA phosphorylation in T-CLL was unexpected because normal B- and T-lymphocytes contain equal amounts of CdA phosphorylation. With B-CLL, 21 patients who responded (complete and partial response) to CdA treatment showed a significantly higher CdA phosphorylation than 13 patients not responding to CdA treatment (456 +/- 170 pmol/mg/min versus 309 +/- 97 pmol/mg/min, P < 0.01). We conclude that the level of CdA phosphorylation is correlated with the response of leukaemias to CdA treatment.


Subject(s)
Cladribine/blood , Leukemia, Hairy Cell/drug therapy , Leukocytes, Mononuclear/metabolism , Cladribine/therapeutic use , Humans , Leukemia, Hairy Cell/blood , Leukemia, Lymphocytic, Chronic, B-Cell/blood , Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy , Leukemia, Prolymphocytic, T-Cell/blood , Leukemia, Prolymphocytic, T-Cell/drug therapy , Phosphorylation
19.
Ther Drug Monit ; 16(4): 413-8, 1994 Aug.
Article in English | MEDLINE | ID: mdl-7974633

ABSTRACT

A reversed-phase high-performance liquid chromatographic (HPLC) method for the simultaneous determination of a new and promising anticancer drug, 2-chloro-2'-deoxyadenosine (CdA), and its metabolite, 2-chloroadenine (CAde), in plasma and urine was developed. A solid-phase extraction procedure with guaneran as internal standard (IS) was used. Plasma (1 ml) or diluted urine (1/100) mixed with 1 ml of phosphate buffer (10 mM, pH 6.5) was applied on a C8 isolute cartridge, which was prewashed with acetonitrile and phosphate buffer. The cartridge was further washed with 2.5 ml of 1% acetonitrile/phosphate buffer and 2.5 ml of hexane/dichloromethane (50/50). The compounds were eluted from the cartridge with 2.5 ml 5% MeOH in ethyl acetate. Chromatographic separation was achieved on C18 column eluted isocratically with phosphate buffer (10 mM, pH 3.0) containing 11% MeOH and 7% acetonitrile, and ultraviolet (UV) detection at 265 nm. Recoveries of CdA and CAde at 100 nmol/L were 90.6 +/- 4.9 and 98.7 +/- 7.8%, respectively. Recovery of IS was 96.1 +/- 6.1% at 250 nmol/l. The inter- and intraday coefficients of variation (CV) were < 10% at different concentrations within the range 1-500 nmol/L for both substances. In plasma, limits of detection of CdA and CAde were 1 and 2 nmol/L, respectively. In urine, the limit of detection was 100 nmol/L for both compounds. Standard curves were linear up to 50 and 500 nmol/L for urine and plasma, respectively. The present method will be a useful tool for further investigations of the pharmacokinetics of CdA in patients treated with different routes of administration.


Subject(s)
Cladribine/analysis , Chromatography, High Pressure Liquid , Cladribine/blood , Cladribine/urine , Female , Humans , Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy , Middle Aged
20.
Acta Pol Pharm ; 51(2): 109-14, 1994.
Article in English | MEDLINE | ID: mdl-7863784

ABSTRACT

The aim of this study was to determine 2-chloro, and 2-bromo derivatives of 2'-deoxyadenosine (2-CdA and 2-BdA respectively) in the serum of human blood by high performance liquid chromatography (HPLC). 2-CdA is a substance with anticancer and immunosuppressive activity. Caffeine or 5,6-dimethylbenzo-1,2,4-triazole-1-beta-D-ribofuranoside was added to 1 cm3 of serum as internal standard. 2-CdA and 2-BdA were isolated from serum using acetone as deproteinizing reagent. LiChrosorb Si 60 column was used for the separation of drugs and the internal standard from endogenous compounds in the sample. A mixture of potassium dihydrophosphate-methanol was used as a mobile phase.


Subject(s)
Cladribine/blood , Deoxyadenosines/blood , Chromatography, High Pressure Liquid , Humans
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