Efficacy of CLARA in recurrent/refractory acute myeloid leukaemia patients unresponsive to FLAG chemotherapy

J Chemother. 2018 Feb;30(1):44-48. doi: 10.1080/1120009X.2017.1396017. Epub 2017 Nov 3.

Abstract

We hereby report our multicentre, retrospective experience with CLARA in patients with fludarabine/cytarabine/G-CSF (FLAG) refractory AML. The study included all consecutive R/R AML patients, who received CLARA salvage during October 2010-October 2015 period. All patients were unresponsive to FLAG salvage chemotherapy regimen and did not undergo previous allo-HCT. A total of 40 patients were included. Following CLARA 5 (12.5%) patients experienced induction mortality and 10 (25%) patients achieved CR. 25 (62.5%) patients were unresponsive to CLARA. 7 (17.5%) out of 10 patients in CR received allo-HCT. Median overall survival of patients who achieved CR after CLARA was 24.5 months (8.5-54.5) and 3 months (2.5-5), in patients who underwent and didn't allo-HCT, respectively. Our results indicate that CLARA may be good alternative even in FLAG refractory AML patients and can be used as a bridge to allo-HCT, who have a suitable donor and able to tolerate the procedure.

Keywords: AML; Acute myeloid leukaemia; Clofarabine; Refractory; Relapse.

Publication types

  • Multicenter Study

MeSH terms

  • Adenine Nucleotides / administration & dosage*
  • Adenine Nucleotides / adverse effects
  • Adolescent
  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Arabinonucleosides / administration & dosage*
  • Arabinonucleosides / adverse effects
  • Clofarabine
  • Cytarabine / administration & dosage*
  • Cytarabine / adverse effects
  • Drug Resistance, Neoplasm / drug effects
  • Female
  • Granulocyte Colony-Stimulating Factor
  • Humans
  • Leukemia, Myeloid, Acute / drug therapy*
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / drug therapy*
  • Retrospective Studies
  • Salvage Therapy / methods*
  • Vidarabine / analogs & derivatives
  • Young Adult

Substances

  • Adenine Nucleotides
  • Arabinonucleosides
  • Cytarabine
  • Granulocyte Colony-Stimulating Factor
  • Clofarabine
  • Vidarabine

Supplementary concepts

  • FLAG protocol