Nelarabine use in leukemias

Drug discovery and development over the past 60 years has played a central role in the continuous improvement in survival rates of patients undergoing treatment for acute lymphoblastic leukemia. It has recently been suggested that in children and adolescents diagnosed with acute lymphoblastic leukemia, an overall cure rate of 90% may be achieved (1, 2). Cure rates in adults, typically less than 40%, are considerably lower than in the younger populations, even in the face of currently prescribed optimal drug therapy and supportive care (3-5). The search for more effective and safer anti-leukemia therapy continues to identify agents and combinations of agents that have activity against specific types of acute lymphoblastic leukemia (1). This review presents a new compound, nelarabine, that has shown efficacy in treating patients with T-cell acute lymphoblastic leukemia or T-cell lymphoblastic lymphoma.