Leukopenia, thrombocytopenia, anemia, and neutropenia commonly occur in bone marrow suppression. Neurotoxicity is dose-limiting toxicity (risk of neurotoxicity may increase in concurrent or previous intrathecal chemotherapy or history of craniospinal irradiation). Appropriate measures must be taken to prevent hyperuricemia and tumor lysis syndrome (use extreme caution in increased uric acid, gout, and history of uric acid stones). Use with caution in hepatic impairment (risk of adverse reactions may be higher with hepatic dysfunction), and in renal impairment. Ara-G clearance may be reduced with renal dysfunction. Administration of live vaccines should be avoided.