The incidence of adverse events is indicated on the basis of clinical trial data, regardless of the cause-and-effect relationship with fludarabine, according to the following gradation: very often (≥10%), often (<10% -≥1%), infrequently (<1% - ≥0,1%), rarely (<0,1% - ≥0,01%).
Infections: very often - joining of secondary infections / opportunistic infections (such as reactivation of latent viruses, including,herpes viruses and Epstein-Barr, progressive multifocal leukoencephalopathy), pneumonia; rarely - lymphoproliferative disorders (associated with the Epstein-Barr virus).
From the hematopoiesis: very often - neutropenia, thrombocytopenia and anemia; often - myelosuppression.
From the immune system: infrequently - autoimmune disorders (including autoimmune hemolytic anemia, thrombocytopenic purpura, pemphigus, Evans syndrome, acquired hemophilia).
On the part of the digestive system: very often - nausea, vomiting, diarrhea; often - stomatitis, mucositis; infrequently - gastrointestinal bleeding, violation of liver enzymes and pancreas.
Metabolic disorders: often - anorexia; infrequently - as a result of tumor lysis hyperuricemia, hyperphosphataemia, hypocalcemia, metabolic acidosis, hyperkalemia, hematuria, urate crystalluria and kidney failure may develop.
From the nervous system: often peripheral neuropathy; infrequently - confusion of consciousness; rarely excitation, convulsions, coma.
From the side of the organ of vision: often - visual impairment; rarely - optic neuritis, visual neuropathy and blindness.
From the respiratory system: very often - cough; infrequently - shortness of breath, pulmonary fibrosis, pneumonitis.
From the cardiovascular system: rarely - heart failure, arrhythmias.
From the genitourinary system: rarely - hemorrhagic cystitis.
From the skin and skin appendages: often - skin rash; highly rarely Stevens-Johnson syndrome, toxic epidermal necrolysis (Lyell's syndrome). There have been reports of rare cases of increased growth of existing skin cancer, as well as the development of skin cancer during or after treatment with fludarabine.
Other: very often - an increase in body temperature, fatigue, weakness, often - chills, malaise, swelling.
In patients who received fludarabine before, after or simultaneously with alkylating cytotoxic agents, topoisomerase inhibitors or radiotherapy, myelodysplastic syndrome (MDS) / acute myeloid leukemia (AML) was often observed.