Clofarabine is primarily used in the treatment of pediatric patients with relapsed or refractory acute lymphoblastic leukemia (ALL) after at least two prior regimens. It works by inhibiting DNA synthesis and repair, leading to the death of rapidly dividing cancer cells. The drug is administered intravenously and is often considered when other treatment options have failed. Its use is carefully monitored due to potential side effects, including myelosuppression, infections, and liver toxicity. Clofarabine is also being investigated in clinical trials for its efficacy in treating other types of cancers and hematologic malignancies, offering potential for broader therapeutic applications in the future.