Treating refractory leukemias in childhood, role of clofarabine.

Therapeutics and Clinical Risk Management
Theresa M Harned, Paul S Gaynon

Abstract

Approximately 4000 children and adolescents under the age of 20 years develop acute leukemia per year in the US. Acute lymphoblastic leukemia (ALL) is the most common pediatric cancer. Despite impressive improvements in outcome, relapsed ALL is the fourth most common pediatric malignancy. Therapy for relapsed ALL remains unsatisfactory, and the majority of relapse patients still succumb to leukemia. Between one-third and one-half of patients with acute myelogenous leukemia (AML) relapse, and no standard therapy is recognized for patients with relapsed and/or refractory AML. Novel therapeutic agents are needed to improve the cure rate for relapsed ALL and AML. Clofarabine is a next-generation nucleoside analog, designed to incorporate the best features and improve the therapeutic index of cladribine and fludarabine. Clofarabine inhibits both DNA polymerase and ribonucleotide reductase, leading to impaired DNA synthesis and repair, and directly induces apoptosis. Phase I and II single-agent trials in children have shown that clofarabine is safe and active in both myeloid and lymphoid relapsed/refractory acute leukemias. Clofarabine has been approved by the FDA for pediatric patients with relapsed/refractory ALL after at least 2 p...Continue Reading

Citations

Jun 7, 2017·Journal of Oncology Pharmacy Practice : Official Publication of the International Society of Oncology Pharmacy Practitioners·Ryan K DasGuptaAnthony J Perissinotti
Jul 1, 2011·Journal of Pediatric Hematology/oncology·Lucas MorenoAmparo Verdeguer
Jan 9, 2010·Journal of Pediatric Hematology/oncology·Birol BaytanOsman Dönmez
Feb 17, 2017·Journal of Adolescent and Young Adult Oncology·Angela DautiAntoinette Anazodo
Jun 26, 2020·Journal of Experimental Pharmacology·Fatemeh PourrajabAzam Sadat Hashemi
Dec 1, 2009·Cases Journal·Elisa Dorantes-AcostaAurora Medina-Sanson

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Methods Mentioned

BETA
flow cytometry
PCR

Software Mentioned

Clolar

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