TY - JOUR
T1 - Clofarabine-containing conditioning regimen for allo-SCT in AML/ALL patients
T2 - A survey from the Acute Leukemia Working Party of EBMT
AU - Chevallier, Patrice
AU - Labopin, Myriam
AU - Buchholz, Stefanie
AU - Ganser, Arnold
AU - Ciceri, Fabio
AU - Lioure, Bruno
AU - Faul, Chistoph
AU - Guillerm, Gaelle
AU - Finke, Juergen
AU - Huynh, Anne
AU - Schubert, Joerg
AU - Kolb, Hans Jochem
AU - Polge, Emmanuelle
AU - Nagler, Arnon
AU - Mohty, Mohamad
PY - 2012/9
Y1 - 2012/9
N2 - 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.
AB - 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.
KW - Acute leukemia working party
KW - Acute lymphoblastic leukemia
KW - Acute myeloid
KW - Allogeneic stem-cell transplantation
KW - Clofarabine
KW - Reduced-toxicity conditioning
UR - http://www.scopus.com/inward/record.url?scp=84865108473&partnerID=8YFLogxK
U2 - 10.1111/j.1600-0609.2012.01822.x
DO - 10.1111/j.1600-0609.2012.01822.x
M3 - Article
C2 - 22702414
AN - SCOPUS:84865108473
SN - 0902-4441
VL - 89
SP - 214
EP - 219
JO - European Journal of Haematology
JF - European Journal of Haematology
IS - 3
ER -