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Clofarabine‐containing conditioning regimen for allo‐ SCT in AML / ALL patients: a survey from the Acute Leukemia Working Party of EBMT
Author(s) -
Chevallier Patrice,
Labopin Myriam,
Buchholz Stefanie,
Ganser Arnold,
Ciceri Fabio,
Lioure Bruno,
Faul Chistoph,
Guillerm Gaelle,
Finke Juergen,
Huynh Anne,
Schubert Joerg,
Kolb HansJochem,
Polge Emmanuelle,
Nagler Ar,
Mohty Mohamad
Publication year - 2012
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/j.1600-0609.2012.01822.x
Subject(s) - clofarabine , medicine , regimen , gastroenterology , conditioning regimen , transplantation , conditioning , acute leukemia , leukemia , surgery , oncology , cytarabine , hematopoietic stem cell transplantation , statistics , mathematics
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.