Allo-SCT conditioning for myelodysplastic syndrome and acute myeloid leukemia with clofarabine, cytarabine and ATG

Bone Marrow Transplantation
M G MartinR Vij

Abstract

The application of myeloablative Allo-SCT is limited by its associated morbidity and mortality. Reduced-intensity conditioning regimens attempt to diminish these, but are associated with a higher risk of disease relapse. Given the evidence of activity of clofarabine and cytarabine in myelodysplastic syndrome/acute myeloid leukemia (MDS/AML), we explored a novel reduced-intensity conditioning regimen based on this backbone. Patients received clofarabine 40 mg/m(2) i.v. on days -6 to -2, cytarabine 1 g/m(2) i.v. on days -6 to -2 and anti-thymocyte globulin (ATG) 1 mg/kg on day -4 and 2.5 mg/kg x 2 days on days -3 and -2. Seven patients were enrolled. Their median age was 54 years; three were with MDS and four with AML. The median duration of neutropenia was 14 days and that of thrombocytopenia was 22 days. Toxicities included hand-foot syndrome (57% grade 2), elevated alanine aminotransferase (ALT) (57% grade 3), elevated aspartate aminotransferase (AST) (86% grade 3) and hyperbilirubinemia (29% grade 3-5). No acute GVHD was observed. Enrollment to the trial was halted after three of the first seven patients expired on days +15, +26 and +32. Three of the four surviving patients have relapsed with a median TTP of 152 days. This re...Continue Reading

References

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Citations

Jun 2, 2012·Clinical Medicine Insights. Oncology·Tara L Lin, M Yair Levy
Sep 11, 2012·Leukemia & Lymphoma·Hady GhanemElias Jabbour
Jun 10, 2009·Expert Opinion on Drug Safety·Ulrike BacherAxel Rolf Zander
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Nov 15, 2011·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Koen van BesienAndrew S Artz
Dec 3, 2014·Critical Reviews in Oncology/hematology·Claudio Fozza
Oct 7, 2011·Cancer Control : Journal of the Moffitt Cancer Center·Mehdi HamadaniMohamed A Kharfan-Dabaja
Oct 13, 2019·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Jacopo PeccatoriFabio Ciceri

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