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Clofarabine-based chemotherapy as a bridge to transplant in the setting of refractory or relapsed acute myeloid leukemia, after at least one previous unsuccessful salvage treatment containing fludarabine: a single institution experience
- Source :
- International journal of hematology. 105(6)
- Publication Year :
- 2016
-
Abstract
- For refractory or relapsed acute myeloid leukemia patients, allogeneic hematopoietic stem cell transplantation is the only curative treatment option, but the disease must be in remission before this can be attempted. “Salvage” therapy regimens containing high-dose cytarabine plus fludarabine or cladribine with or without anthracyclines or plus mitoxantrone and etoposide fail in 30–50% of cases. We report the outcome of 14 patients treated with a clofarabine-based treatment administered after at least one failed fludarabine-based “salvage” attempt in a “real life” (outside a clinical trial) context. No death related to the clofarabine-based treatment was observed. Four of the 14 patients (29%) reached complete remission and one (7%) achieved a reduction of marrow blasts to fewer than 10%. Three of these five patients were successfully transplanted and have shown a long-term survival. The small number of this group of patients does not permit the identification of clinical features clearly related to a favorable outcome, but we note that all the three long-term survivals were FLT3 wild type. Clofarabine-based “salvage therapy” in patients with very poor expectancy is feasible even after a fludarabine-based salvage attempt, albeit with success only in a small percentage of cases (3/14 = 21%).
- Subjects :
- Adult
Male
medicine.medical_specialty
Relapsed/refractory AML
Adolescent
medicine.medical_treatment
Salvage therapy
Hematopoietic stem cell transplantation
Disease-Free Survival
03 medical and health sciences
0302 clinical medicine
Recurrence
medicine
Clofarabine
Humans
Etoposide
Aged
Retrospective Studies
Salvage Therapy
Mitoxantrone
Chemotherapy
business.industry
Adenine Nucleotides
Hematopoietic Stem Cell Transplantation
Hematology
Middle Aged
Allografts
Surgery
Fludarabine
Leukemia, Myeloid, Acute
030220 oncology & carcinogenesis
Cytarabine
Female
Arabinonucleosides
business
Vidarabine
030215 immunology
medicine.drug
Subjects
Details
- ISSN :
- 18653774
- Volume :
- 105
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- International journal of hematology
- Accession number :
- edsair.doi.dedup.....4dc798ff992897b6720096ea0eb21553