title: Clofarabine-based chemotherapy for relapsed/refractory adult acute lymphoblastic leukemia and lymphoblastic lymphoma. The Spanish experience.
abstract: The present study reports the Spanish PETHEMA group experience in 31 heavily pretreated relapsed/refractory acute lymphoblastic leukemia (ALL) and lymphoma (LL) patients treated with clofarabine-based regimens. The complete remission (CR) rate was 31% (median CR duration of 3 months [range 2–28]) and the overall survival probability at 1 year was 10% (95%CI 4–16%). Responses were seen in B and T lineage diseases and in patients with adverse cytogenetics. Hematological and infectious grade >3 toxicities were found in 100 and 67% of the patients, respectively, with 7 (23%) treatment-related deaths. Other organ toxicities were infrequent. Clofarabine-based chemotherapy regimens might induce CRs in ALL and LL patients, but hematological toxicity and infections may limit their use in heavily pretreated patients.
authors.affiliation: Hematology Departments of Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain. pebarba@vhebron.net
authors.forename: Pere
authors.initials: P
authors.lastname: Barba
authors.forename: Antonia
authors.initials: A
authors.lastname: Sampol
authors.forename: María
authors.initials: M
authors.lastname: Calbacho
authors.forename: José
authors.initials: J
authors.lastname: Gonzalez
authors.forename: Josefina
authors.initials: J
authors.lastname: Serrano
authors.forename: Pilar
authors.initials: P
authors.lastname: Martínez-Sánchez
authors.forename: Pascual
authors.initials: P
authors.lastname: Fernández
authors.forename: Raimundo
authors.initials: R
authors.lastname: García-Boyero
authors.forename: Javier
authors.initials: J
authors.lastname: Bueno
authors.forename: Josep Maria
authors.initials: JM
authors.lastname: Ribera
mesh_terms: D000227:Adenine Nucleotides / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000293:Adolescent; D000328:Adult; D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001087:Arabinonucleosides / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000077866:Clofarabine; D003520:Cyclophosphamide / Q000008:administration & dosage; D003561:Cytarabine / Q000008:administration & dosage; D004341:Drug Evaluation; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D056687:Off-Label Use; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy*; D012189:Retrospective Studies; D016879:Salvage Therapy; D013030:Spain; D055815:Young Adult
chemical_list: D000227:Adenine Nucleotides; D000964:Antimetabolites, Antineoplastic; D001087:Arabinonucleosides; D003561:Cytarabine; D005047:Etoposide; D000077866:Clofarabine; D003520:Cyclophosphamide