Synonyms
Fludarabine 5'-monophosphate; Oforta; Fludarabine monophosphate; 2-F-ara-AMP; NSC-312887; 2-Fluoro-9-(5-O-phosphono-beta-D-arabinofuranosyl)-9H-purin-6-amine; 1X9VK9O1SC
Molecular Formula
C10H13FN5O7P
Smiles
C1=NC2=C(N=C(N=C2N1[C@H]3[C@H]([C@@H]([C@H](O3)COP(=O)(O)O)O)O)F)N
Appearance
White to light yellow crystalline powder
General Description
Fludarabine phosphate is a purine nucleoside analogue with potent antineoplastic and immunosuppressive activity, used primarily in the treatment of hematologic malignancies. It is administered intravenously or orally and is a prodrug that is rapidly dephosphorylated to fludarabine, then intracellularly converted to its active triphosphate form. The drug is a cornerstone of therapy for chronic lymphocytic leukemia.
Mechanism of Action
Fludarabine triphosphate incorporates into DNA during replication, inhibiting DNA polymerase and ribonucleotide reductase, leading to chain termination and inhibition of DNA synthesis. It also induces apoptosis in both dividing and resting lymphocytes by interfering with DNA repair processes. The drug is particularly active against indolent B-cell malignancies due to its selective toxicity to lymphoid cells, which have low deoxycytidine kinase activity but efficient fludarabine phosphorylation.
Application
It is indicated for the treatment of B-cell chronic lymphocytic leukemia (CLL) in patients who have not responded to or have progressed after first-line alkylator-based therapy. It is also used in combination regimens for non-Hodgkin lymphoma and acute myeloid leukemia. In allogeneic stem cell transplantation, it serves as part of reduced-intensity conditioning protocols due to its potent immunosuppressive properties. Myelosuppression, immunosuppression with opportunistic infections, and dose-related neurotoxicity are significant adverse effects.
The fluorinated purine analogue fludarabine, already used in hematologic malignancies, was tested against several RNA viruses, including Zika virus, severe fever with thrombocytopenia syndrome virus (SFTSV), and enterovirus A71 (EV‑A71). In multiple cell lines (Vero, BHK21, U251 MG, HMC3), fludarabine inhibited viral infection with IC₅₀ values below 1 μM. Cytotoxicity occurred only at much higher concentrations, suggesting a favorable therapeutic window. The authors propose that fludarabine could be repurposed as a broad‑spectrum anti‑RNA virus therapeutic, though further in vivo and clinical studies are needed.
Fig. 1 Fludarabine inhibited infection of ZIKV. (Gao C, et al., 2021)
References
- Gao C, et al. Fludarabine Inhibits Infection of Zika Virus, SFTS Phlebovirus, and Enterovirus A71. Viruses. 2021; 13(5):774.
Does Fludarabine Phosphate require strict cold chain storage as a purine analog?
Yes, it must be stored at 2-8°C (refrigerated). At room temperature, hydrolysis of the phosphate group and degradation of the purine ring occur rapidly.
Is Fludarabine Phosphate sensitive to light during handling and storage?
Yes, it is photosensitive. Store in light-resistant containers and handle under subdued light to prevent photodegradation.
What is the stability of Fludarabine Phosphate after reconstitution for intravenous use?
Reconstituted solutions have limited stability (typically 24-48 hours under refrigeration). We provide detailed in-use stability data for various diluents, including saline and D5W.
How is the impurity 2-fluoroadenine monitored during stability?
This primary degradation product is specifically quantified using a stability-indicating HPLC method, ensuring it remains well below ICH limits.