Ocular toxicity of fludarabine: a purine analog
Xiaoyan Ding1, Alexandra A Herzlich, Rachel Bishop
1Section of Immunopathology, Laboratory of Immunology, National Eye Institute, National Institutes of Health, Bethesda, MD, USA; And, Zhongshan Ophthalmic Center, Sun Yet-sen University, Guangzhou, China.
Abstract:
The purine analogs, fludarabine and cladribine represent an important class of chemotherapy agents used to treat a broad spectrum of lymphoid malignancies. Their toxicity profiles include dose-limiting myelosuppression, immunosuppression, opportunistic infection and severe neurotoxicity. This review summarizes the neurotoxicity of high- and standard-dose fludarabine, focusing on the clinical and pathological manifestations in the eye. The mechanisms of ocular toxicity are probably multifactorial. With increasing clinical use, an awareness of the neurological and ocular vulnerability, particularly to fludarabine, is important owing to the potential for life- and sight-threatening consequences.
Related Concept Videos
Drug Toxicity: Overview
Drug Toxicity: Dose-Dependent Reactions
Drug toxicity: Idiosyncratic Reactions
Drug Toxicity: Risk factors
Renal Failure: Dose Adjustments
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
Drug Toxicity: Allergic Reactions

