Clofarabine-containing conditioning regimen for allo-SCT in AML/ALL patients: A survey from the Acute Leukemia Working Party of EBMT

Patrice Chevallier, Myriam Labopin, Stefanie Buchholz, Arnold Ganser, Fabio Ciceri, Bruno Lioure, Chistoph Faul, Gaelle Guillerm, Juergen Finke, Anne Huynh, Joerg Schubert, Hans Jochem Kolb, Emmanuelle Polge, Arnon Nagler, Mohamad Mohty

Research output: Contribution to journalArticlepeer-review

Abstract

Clofarabine (CLO), a second-generation purine analogue, has demonstrated an efficient anti-leukemia activity while showing a favorable toxicity profile. This retrospective multicenter report assessed the outcome of 90 patients who received a CLO-containing conditioning regimen before allo-SCT for AML (n = 69) or ALL (n = 21). Median age was 42 yr at transplant. The majority of cases (n = 66) presented with an active disease at transplant while 38 patients had received previous transplantation(s). A total of 88 and two patients received a reduced-intensity conditioning or a myeloablative regimen, respectively. Engraftment was achieved in 97% of evaluable patients. With a median follow-up of 14 months (range, 1-45), the 2-year OS, LFS, relapse, and NRM rates were 28 ± 5%, 23 ± 5%, 41 ± 6%, and 35 ± 5%, respectively. When comparing AML and ALL patients, OS and LFS were significantly higher for AML (OS, 35 ± 6% vs. 0%, P <0.0001); LFS: 30 ± 6% vs. 0%, P <0.0001). In a Cox multivariate analysis, an AML diagnosis was the only factor associated with a better LFS (HR = 0.37; 95%CI, 0.21-0.66; P = 0.001). We conclude that a CLO-containing conditioning regimen prior to allo-SCT might be an effective treatment. Prospective studies are needed to evaluate the potential role of CLO as part of conditioning regimens in acute leukemias.

Original languageEnglish
Pages (from-to)214-219
Number of pages6
JournalEuropean Journal of Haematology
Volume89
Issue number3
DOIs
Publication statusPublished - Sep 2012

Keywords

  • Acute leukemia working party
  • Acute lymphoblastic leukemia
  • Acute myeloid
  • Allogeneic stem-cell transplantation
  • Clofarabine
  • Reduced-toxicity conditioning

ASJC Scopus subject areas

  • Hematology

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