A real-world study of clofarabine and cytarabine combination therapy for patients with acute myeloid leukemia

Leuk Lymphoma. 2018 Oct;59(10):2352-2359. doi: 10.1080/10428194.2018.1433297. Epub 2018 Feb 7.

Abstract

Clofarabine and cytarabine (Clo + Ara-C) combinations have efficacy in treatment of acute myeloid leukemia (AML). We retrospectively analyzed clinical outcomes of 71 AML patients receiving Clo + Ara-C regimens at the University of Minnesota from 2011 to 2016: 44 patients (62%) had newly diagnosed AML and 27 patients (38%) had relapsed/refractory AML. The median age of patients was 69 years (interquartile range [IQR], 63-75 years). Nearly 60% of the patients had secondary AML, and about half of patients had adverse risk cytogenetics. Objective response rate (ORR) was 42% in all patients with complete remission (CR) rate of 20%. Progression-free survival (PFS) at 2 years was 16% (95% CI 8-27%) and overall survival (OS) at 2 years was 21% (95% CI 11-33%) for all patients. The 30-day mortality rate was 18%. Clo + Ara-C- containing regimens are an acceptable upfront therapy option for patients who are not candidates for "7 + 3" induction, but do not induce durable remissions.

Keywords: Ara-c; Clofarabine; acute myeloid leukemia; chemotherapeutic approaches; cytarabine; myeloid leukemias and dysplasias.

MeSH terms

  • Age Factors
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Clofarabine / therapeutic use*
  • Cytarabine / therapeutic use*
  • Drug Administration Schedule
  • Female
  • Humans
  • Leukemia, Myeloid, Acute / drug therapy*
  • Leukemia, Myeloid, Acute / mortality
  • Male
  • Middle Aged
  • Minnesota / epidemiology
  • Progression-Free Survival
  • Remission Induction / methods
  • Retrospective Studies
  • Salvage Therapy / methods

Substances

  • Cytarabine
  • Clofarabine