Delayed-onset effect of clofarabine in the treatment of an adult patient with acute myeloid leukemia

American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists
Robert WalchackAbraham S Kanate

Abstract

A delayed-onset effect of clofarabine in the treatment of an adult patient with acute myeloid leukemia (AML) is reported. A 44-year-old African-American man with pancytopenia was transferred to an academic medical center for evaluation. His medical history included bipolar depression, gynecomastia, and HIV infection (diagnosed 5 years prior) for which he was being treated with atazanavir, emtricitabine-tenofovir, and ritonavir. He was diagnosed with AML with 60% myeloblasts found during bone marrow biopsy. He had primary refractory disease after induction chemotherapy treatment. His disease was refractory to subsequent therapy with high-dose cytarabine and then etoposide and mitoxantrone. The patient then underwent treatment with granulocyte-colony stimulating factor-primed clofarabine and cytarabine (G-CLAC). At blood count recovery, he was diagnosed with refractory disease, with 17% blasts in peripheral blood and was subsequently discharged home on hospice 38 days after G-CLAC and 19 days after the last dose of filgrastim. He arrived at the outpatient clinic 79 days after G-CLAC chemotherapy with significantly improved blood counts. Two weeks later, a bone marrow biopsy confirmed complete remission with incomplete hematologic...Continue Reading

References

Apr 12, 2001·British Journal of Haematology·L SuttonUNKNOWN French Study Group on Acute Myeloid Leukaemia in HIV-Infected Patients
Mar 29, 2002·AIDS·David M AboulafiaBruce J Dezube
May 16, 2012·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Stefan FaderlHagop M Kantarjian
Nov 16, 2012·American Journal of Hematology·Barbara ScappiniAlberto Bosi
Jul 11, 2013·Blood·Alan K BurnettUNKNOWN UK National Cancer Research Institute AML Working Group

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