Cladribine in the treatment of acute myeloid leukemia: a single-institution experience.
BACKGROUND
Despite advances in novel therapeutics, supportive care, and postremission therapy, the outcome of high-risk and elderly patients as well as those with relapsed/refractory acute myeloid leukemia (AML) remains poor. There is likely still room for improvement through optimizing conventional chemotherapy.


METHODS
Through a pharmacy database search we identified all patients with AML treated at Washington University with cladribine-based regimens.


RESULTS
Twenty-four patients were identified that were treated with 2 cladribine-based regimens: CLAG (cladribine [5 mg/m2 days 1-5], cytarabine [2 g/m2 days 1-5] and granulocyte colony-stimulating factor [G-CSF; 300 microg subcutaneously (s.c.) days 0-5]) and CLAM (cladribine [5 mg/m2 days 1-5], cytarabine [2 g/m2 days 1-5], G-CSF [300 mg s.c. days 0-5] and mitoxantrone [10 mg/m2 days 1-3]). Complete responses were achieved in 53% of patients given induction chemotherapy and 44% of those given salvage chemotherapy. The regimens were well tolerated with minimal extramedullary toxicity.


CONCLUSIONS
These data suggest that cladrabine-based regimens should be further explored in both the salvage and first-line setting and might offer an attractive backbone on which to add novel therapies.
Martin
Mike G
MG
Section of Leukemia and Bone Marrow Transplantation, Division of Oncology, Washington University School of Medicine, Saint Louis, MO 63110, USA. mmartin@dom.wustl.edu
Welch
John S
JS
Augustin
Kristan
K
Hladnik
Lindsay
L
DiPersio
John F
JF
Abboud
Camille N
CN
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D017338:Cladribine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007279:Injections, Subcutaneous; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D016879:Salvage Therapy; D016896:Treatment Outcome; D055815:Young Adult
D017338:Cladribine