title: Clofarabine for the treatment of adult acute lymphoid leukemia: the Group for Research on Adult Acute Lymphoblastic Leukemia intergroup.
abstract: Clofarabine, a second-generation purine analog displaying potent inhibition of DNA synthesis and favorable pharmacologic profile, is approved for the treatment of acute lymphoblastic leukemia (ALL) after failure of at least two previous regimens in patients up to 21 years of age at diagnosis. Good neurologic tolerance, synergy with alkylating agents, management guidelines defined through pediatric ALL and adult acute myeloid leukemia, have also prompted its administration in more than 100 adults with Philadelphia chromosome-positive and negative B lineage and T lineage ALL, as single agent (40 mg/m(2)/ day for 5 days), or in combination. In a Group for Research on Adult Acute Lympho- blastic Leukemia (GRAALL) retrospective study of two regimens (clofarabine ± cyclophosphamide + / - etoposide (ENDEVOL) ± mitoxantrone ± asparaginase ± dexamethasone (VANDEVOL)), remission was achieved in 50% of 55 relapsed/refractory patients, and 17-35% could proceed to allogeneic stem cell. Clofarabine warrants further exploration in advanced ALL treatment and bridge-to-transplant.
authors.affiliation: Department of Hematology, Hôpital Purpan , Toulouse , France.
authors.forename: Françoise
authors.initials: F
authors.lastname: Huguet
authors.forename: Thibaut
authors.initials: T
authors.lastname: Leguay
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Raffoux
authors.forename: Philippe
authors.initials: P
authors.lastname: Rousselot
authors.forename: Norbert
authors.initials: N
authors.lastname: Vey
authors.forename: Arnaud
authors.initials: A
authors.lastname: Pigneux
authors.forename: Norbert
authors.initials: N
authors.lastname: Ifrah
authors.forename: Hervé
authors.initials: H
authors.lastname: Dombret
mesh_terms: D000227:Adenine Nucleotides / Q000008:administration & dosage / Q000627:therapeutic use*; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001087:Arabinonucleosides / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D000077866:Clofarabine; D004305:Dose-Response Relationship, Drug; D006801:Humans; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy* / Q000628:therapy; D012074:Remission Induction; D033581:Stem Cell Transplantation / Q000379:methods; D016896:Treatment Outcome
chemical_list: D000227:Adenine Nucleotides; D001087:Arabinonucleosides; D000077866:Clofarabine
keywords: Clofarabine; acute lymphoblastic leukemia; adults; purine analogs