cladribine + peginterferon alfa-2a

This is a combination therapy consisting of cladribine and pegylated interferon alfa-2a (PEG-IFN-α2a). Cladribine is a purine nucleoside analog that closely resembles the molecular structure of deoxyadenosine. Upon uptake by dividing and nondividing lymphocytes via nucleoside transporter proteins, cladribine is converted intracellularly to cladribine triphosphate. This accumulates in lymphocytes due to high levels of deoxycytidine kinase and low levels of 5′-nucleotidase. Cladribine triphosphate competes with adenine triphosphate in DNA synthesis, leading to DNA strand breaks and ultimately causing apoptosis or autophagy in dividing and resting lymphocytes[2]. Peginterferon alfa-2a is a covalent conjugate of recombinant alfa-2a interferon with a branched 40 kDa PEG chain attached to lysine residues. It acts by binding to human type 1 interferon receptors, causing them to dimerize and activate the JAK/STAT pathway. This increases expression of multiple genes involved in the innate antiviral response[1][6]. The pegylation improves pharmacokinetics, allowing for once-weekly dosing instead of three times a week with unmodified interferon[6]. According to search result [4], purine nucleoside analogs (PNAs) such as cladribine and pentostatin have replaced interferon alfa as standard first-line therapy for hairy cell leukemia, though current NCCN guidelines suggest interferon alfa therapy for certain patients.

Other names

Cladribine and pegylated interpheron alpha-2aSubcutaneous Cladribine Plus Pegylated Interpheron Alfa-2a