Nelarabine is a cancer medicine that interferes with the growth and spread of cancer cells in the body.

Nelarabine is used to treat T-cell acute lymphoblastic leukemia and T-cell lymphoblastic lymphoma.

Nelarabine may also be used for purposes not listed in this medication guide.

Nelarabine may cause serious side effects on your central nervous system. Call your doctor right away if you have severe drowsiness, numbness and tingling in your hands or feet, problems with walking, loss of balance or coordination, or trouble using your fingers.

Avoid getting pregnant while using nelarabine and for at least 3 months after your last dose.

Nelarabine is given as an infusion into a vein. A healthcare provider will give you this injection.

This medicine must be given slowly, and the infusion can take up to 2 hours to complete.

Nelarabine can lower your blood cell counts. Your blood will need to be tested often. Your cancer treatments may be delayed based on the results.

You should not be treated with nelarabine if you are allergic to it.

Tell your doctor if you have ever had:

• liver disease;

• kidney disease;

• a nervous system disorder; or

• prior chemotherapy or radiation treatment of your head, neck, or spinal cord.

You may need to have a negative pregnancy test before starting this treatment.

Do not use nelarabine if you are pregnant. It could harm the unborn baby. Use effective birth control to prevent pregnancy while you are using nelarabine and for at least 3 months after your last dose.

A man receiving nelarabine should use a condom during treatment, and for at least 3 months after treatment ends.

You should not breast-feed while you are receiving nelarabine.

Call your doctor for instructions if you miss an appointment for your nelarabine injection.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include severe forms of some of the side effects listed in this medication guide.

Avoid driving or hazardous activity until you know how nelarabine will affect you. Your reactions could be impaired. You may feel drowsy for several days after you are treated with nelarabine.

Avoid being near people who are sick or have infections. Tell your doctor at once if you develop signs of infection.

Do not receive a "live" vaccine while using nelarabine. Live vaccines include measles, mumps, rubella (MMR), polio, rotavirus, typhoid, yellow fever, varicella (chickenpox), and zoster (shingles).

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Nelarabine may cause serious side effects of the central nervous system. These symptoms may not go away even after you stop receiving nelarabine. Tell your doctor if you have:

• extreme drowsiness;

• loss of balance or coordination;

• problems with walking;

• numbness or tingly feeling in your hands or feet;

• problems with buttoning clothes or picking up small items with your fingers;

• a seizure; or

• weakness or loss of movement in any part of your body.

Also call your doctor at once if you have:

• unexplained muscle pain, tenderness, or weakness;

• low blood cell counts--fever, chills, tiredness, mouth sores, skin sores, easy bruising, unusual bleeding, pale skin, cold hands and feet, feeling light-headed or short of breath; or

• signs of tumor cell breakdown--tiredness, weakness, muscle cramps, nausea, vomiting, diarrhea, fast or slow heart rate, tingling in your hands and feet or around your mouth.

Common side effects of nelarabine may include:

• drowsiness (for several days after your injection);

• nausea, vomiting, diarrhea, constipation;

• numbness or tingling;

• headache, tiredness; or

• blurred vision.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Other drugs may affect nelarabine, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.