The combination of clofarabine and cytarabine in pediatric relapsed acute lymphoblastic leukemia: a case report.
BACKGROUND
Despite significant advances in treatment and survival rates in pediatric acute leukemias, relapse remains a common reason for treatment failure. Survival following relapse is dismal for most patients. Clofarabine, a purine nucleoside analog, has recently been approved for use in relapsed and refractory pediatric acute lymphoblastic leukemia. Clofarabine and cytarabine together may be synergistic and have been used safely in adult leukemia patients.


METHODS
We describe the administration of this combination to a 9-year-old boy with multiple relapsed T-cell acute lymphoblastic leukemia who failed to achieve remission after the third attempt. He achieved complete morphologic and cytogenetic remission with 1 cycle of this combination.


CONCLUSIONS
This case is the first report of successful remission induction in a multiple relapsed pediatric leukemia patient using the clofarabine and cytarabine combination. Although it is a single case, it highlights the need for further studies to assess safety and efficacy of this combination in pediatric patients.
Gidwani
Pooja
P
Department of Pediatric Hematology/Oncology, Children's Hospital at Montefiore, Montefiore Medical Center, Bronx, NY 10467, USA. pooja_gidwani@yahoo.com
Ramesh
K H
KH
Liu
Yingxian
Y
Kolb
Edward Anders
EA
D000227:Adenine Nucleotides / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D001087:Arabinonucleosides / Q000008:administration & dosage; D002648:Child; D000077866:Clofarabine; D003561:Cytarabine / Q000008:administration & dosage; D006801:Humans; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000097:blood / Q000188:drug therapy* / Q000235:genetics; D008297:Male; D055502:Secondary Prevention
D000227:Adenine Nucleotides; D001087:Arabinonucleosides; D003561:Cytarabine; D000077866:Clofarabine