Comparison of clofarabine activity in childhood and adult acute leukemia: individual tumor response study.
BACKGROUND
Clofarabine is a second-generation nucleoside analogue. The aim of the study was the analysis of ex vivo activity of clofarabine and 14 other anticancer drugs in pediatric and adult acute lymphoblastic (ALL) and myeloid (AML) leukemia.


METHODS
The ex vivo drug resistance profile was analyzed in 282 patients, including 201 children with ALL de novo, 24 children with relapsed ALL, 25 children with AML de novo and 32 adults with AML. Cellular ex vivo drug resistance was tested by means of the MTT assay.


RESULTS
Clofarabine had comparable ex vivo activity against lymphoblasts and myeloblasts, both on initial diagnosis and at relapse, both in children and in adults. Its activity in acute myeloid leukemia was independent of patient age. No significant differences in drug resistance to clofarabine between pediatric age-based subgroups of ALL were detected, while it was observed for most of other drugs. An activity of clofarabine in relapsed pediatric ALL patients was as good as in newly-diagnosed ones.


CONCLUSIONS
In comparison to childhood acute lymphoblastic leukemia, lack of differences in ex vivo activity gives rationale for use of clofarabine in refractory and relapsed pediatric and adult patients with acute myeloid leukemia.
Styczynski
Jan
J
Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University, ul. Curie-Sklodowskiej 9, 85-094 Bydgoszcz, Poland. jstyczynski@cm.umk.pl
Gil
Lidia
L
Derwich
Katarzyna
K
Wachowiak
Jacek
J
Balwierz
Walentyna
W
Badowska
Wanda
W
Krawczuk-Rybak
Maryna
M
Matysiak
Michal
M
Wieczorek
Maria
M
Balcerska
Anna
A
Sonta-Jakimczyk
Danuta
D
Stefaniak
Jolanta
J
Kowalczyk
Jerzy
J
Urasinski
Tomasz
T
Sobol
Grazyna
G
Komarnicki
Mieczyslaw
M
Wysocki
Mariusz
M
D000208:Acute Disease; D000227:Adenine Nucleotides / Q000627:therapeutic use*; D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001087:Arabinonucleosides / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D000077866:Clofarabine; D006801:Humans; D007223:Infant; D007938:Leukemia / Q000188:drug therapy*; D008875:Middle Aged; D016896:Treatment Outcome; D055815:Young Adult
D000227:Adenine Nucleotides; D000970:Antineoplastic Agents; D001087:Arabinonucleosides; D000077866:Clofarabine