TY - JOUR
T1 - Clofarabine, cyclophosphamide and etoposide for the treatment of relapsed or resistant acute leukemia in pediatric patients
AU - Miano, Maurizio
AU - Pistorio, Angela
AU - Putti, Maria C.
AU - Dufour, Carlo
AU - Messina, Chiara
AU - Barisone, Elena
AU - Ziino, Ottavio
AU - Parasole, Rosanna
AU - Luciani, Matteo
AU - Lo Nigro, Luca
AU - Rossi, Giulio De
AU - Varotto, Stefania
AU - Bertorello, Nicoletta
AU - Petruzziello, Fara
AU - Calvillo, Michaela
AU - Micalizzi, Concetta
PY - 2012/9
Y1 - 2012/9
N2 - Clofarabine is a promising new chemotherapeutic agent that is active in the treatment of pediatric acute leukemia. Forty children (16 with acute myeloid leukemia [AML], 24 with acute lymphoblastic leukemia [ALL]), aged 1-20 years (median 7.6 years) with relapsed or refractory ALL or AML were treated because of resistance to first-line treatment (n = 5), or for first (n = 22), second (n = 11) or third relapse (n = 2). They received clofarabine (40 mg/m 2/day) associated with etoposide (100 mg/m2/day) and cyclophosphamide (440 mg/m2/day) administered as one or two induction cycles (5 days of chemotherapy) in an attempt to reach complete remission (CR) or CR without platelet recovery (CRp). This was followed by 1-3 consolidation cycles (4 days of chemotherapy) for a maximum of four cycles. Seven (44%) out of 16 and 10 (42%) out of 24 evaluable children with AML and ALL, respectively, responded to treatment. The most common adverse events were infections and gastrointestinal and hepatic toxicity. Thirteen (76%) out of 17 responders underwent hematopoietic stem cell transplant. The 24-month overall survival was 25%, while it was 59% among patients who responded to the first induction cycle. Our study suggests that this drug regimen is well tolerated and can be effective in heavily pretreated pediatric patients with relapsed or refractory acute leukemia.
AB - Clofarabine is a promising new chemotherapeutic agent that is active in the treatment of pediatric acute leukemia. Forty children (16 with acute myeloid leukemia [AML], 24 with acute lymphoblastic leukemia [ALL]), aged 1-20 years (median 7.6 years) with relapsed or refractory ALL or AML were treated because of resistance to first-line treatment (n = 5), or for first (n = 22), second (n = 11) or third relapse (n = 2). They received clofarabine (40 mg/m 2/day) associated with etoposide (100 mg/m2/day) and cyclophosphamide (440 mg/m2/day) administered as one or two induction cycles (5 days of chemotherapy) in an attempt to reach complete remission (CR) or CR without platelet recovery (CRp). This was followed by 1-3 consolidation cycles (4 days of chemotherapy) for a maximum of four cycles. Seven (44%) out of 16 and 10 (42%) out of 24 evaluable children with AML and ALL, respectively, responded to treatment. The most common adverse events were infections and gastrointestinal and hepatic toxicity. Thirteen (76%) out of 17 responders underwent hematopoietic stem cell transplant. The 24-month overall survival was 25%, while it was 59% among patients who responded to the first induction cycle. Our study suggests that this drug regimen is well tolerated and can be effective in heavily pretreated pediatric patients with relapsed or refractory acute leukemia.
KW - Clofarabine
KW - hematopoietic stem cell transplant
KW - relapsed/resistant pediatric leukemia
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UR - http://www.scopus.com/inward/citedby.url?scp=84861721732&partnerID=8YFLogxK
U2 - 10.3109/10428194.2012.663915
DO - 10.3109/10428194.2012.663915
M3 - Article
C2 - 22303898
AN - SCOPUS:84861721732
VL - 53
SP - 1693
EP - 1698
JO - Leukemia and Lymphoma
JF - Leukemia and Lymphoma
SN - 1042-8194
IS - 9
ER -