clofarabine + PEG-asparaginase

Combination chemotherapy regimen consisting of clofarabine, a second-generation purine nucleoside antimetabolite, and PEG-asparaginase (pegaspargase), an asparagine-depleting enzyme. Clofarabine inhibits ribonucleotide reductase and DNA polymerases, depleting deoxynucleotide pools and causing DNA synthesis/repair arrest and apoptosis. PEG-asparaginase catalyzes the hydrolysis of L-asparagine to aspartic acid and ammonia, depleting extracellular asparagine required by lymphoblasts, leading to selective leukemic cell death. This combination has been investigated primarily in acute lymphoblastic leukemia (ALL), including frontline early consolidation for patients with minimal residual disease (MRD) after induction, where it has shown effective MRD reduction with acceptable toxicity compared to high-dose cytarabine plus PEG-asparaginase.

Other names

clofarabine + pegaspargaseclofarabine + PEG-ASP