title: [Effectiveness of CLAT Protocol for Treating Patients with Refractory Acute Myeloid Leukemia].
abstract: OBJECTIVE
  To explore the clinical efficacy and toxicity of CLAT protocol (cladribine, cytarabine and topotecan) for treating patients with refractory acute myeloid leukemia (R-AML).
  
  
  METHODS
  A total of 18 patients with R-AML (median age 37 years, range 18 to 58 years; male n = 16, female n = 2) were treated with CLAT protocol, which consisted of cladribine 5 mg/m(2)/d, i.v. on days 1-5, cytarabine 1.5 g/m(2)/d, i.v. on days 1-5, topotecan 1.25 mg/m(2)/d, i.v. on days 1-5 and G-CSF 300 µg/d subcutaneous injection on day 6 until neutrophile granulocyte recovery.
  
  
  RESULTS
  Out of 18 patients 2 died of severe infection before the assessment. Among 16 evaluated patients, 10 (55.6%) achieved complete remission (CR), and 2 (11.1%) achieved partial remission (PR), the overall response rate was 66.7%, the rest 4 patients did not respond (NR). The median overall survival time and DFS for the CR patients was 9.5 months (95%CI: 6.7-16.64) and 9.5 months (95%CI: 6.1-16.7) respectively. The 1 year OS and DFS rates were 45% and 46.9%, respectively. All patients developed grade 4 of granulocytopenia and thrombocytopenia, the median duration was 13 (range 2 to 21) days and 12 days (range 2 to 21), respectively, all patients developed infection, 2 patients died of severe infection. The most common non-hematological side effects included nausea, vomiting, diarrhoea, rash, aminotransferase or bilirubin elevation and were grade 1 to 2.
  
  
  CONCLUSIONS
  The CLAT protocol seems to have promising for the treatment of refractory AML patients, and patients well tolerated. This CLAT protocol offers an alternative treatment for R-AML patients who received severe intensive treatment, especially with anthracycline-containing chemotherapy.
authors.affiliation: Second Clinical College, Southern Medical University, Guangzhou 510515, Guangdong Province, China.|Department of Hematology, Guangdong General Hospital/Guangdong Academy of Medical Sciences, Guangzhou 510080, Guangdong Province, China.
authors.forename: Xiao-Mei
authors.initials: XM
authors.lastname: Chen
authors.affiliation: Department of Hematology, Guangdong General Hospital/Guangdong Academy of Medical Sciences, Guangzhou 510080, Guangdong Province, China. E-mail: wengjianyu1969@163.com.
authors.forename: Jian-Yu
authors.initials: JY
authors.lastname: Weng
authors.affiliation: Department of Hematology, Guangdong General Hospital/Guangdong Academy of Medical Sciences, Guangzhou 510080, Guangdong Province, China.
authors.forename: Cheng-Xin
authors.initials: CX
authors.lastname: Deng
authors.affiliation: Department of Hematology, Guangdong General Hospital/Guangdong Academy of Medical Sciences, Guangzhou 510080, Guangdong Province, China.
authors.forename: Yu-Lian
authors.initials: YL
authors.lastname: Wang
authors.affiliation: Department of Hematology, Guangdong General Hospital/Guangdong Academy of Medical Sciences, Guangzhou 510080, Guangdong Province, China.
authors.forename: Zhi
authors.initials: Z
authors.lastname: Chao
authors.affiliation: Department of Hematology, Guangdong General Hospital/Guangdong Academy of Medical Sciences, Guangzhou 510080, Guangdong Province, China.
authors.forename: Pei-Long
authors.initials: PL
authors.lastname: Lai
authors.affiliation: Department of Hematology, Guangdong General Hospital/Guangdong Academy of Medical Sciences, Guangzhou 510080, Guangdong Province, China.
authors.forename: Min-Ming
authors.initials: MM
authors.lastname: Li
authors.affiliation: Department of Hematology, Guangdong General Hospital/Guangdong Academy of Medical Sciences, Guangzhou 510080, Guangdong Province, China.
authors.forename: Peng-Jun
authors.initials: PJ
authors.lastname: Liao
authors.affiliation: Department of Hematology, Guangdong General Hospital/Guangdong Academy of Medical Sciences, Guangzhou 510080, Guangdong Province, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Huang
authors.affiliation: Department of Hematology, Guangdong General Hospital/Guangdong Academy of Medical Sciences, Guangzhou 510080, Guangdong Province, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Ling
authors.affiliation: Department of Hematology, Guangdong General Hospital/Guangdong Academy of Medical Sciences, Guangzhou 510080, Guangdong Province, China.
authors.forename: Chang-Chun
authors.initials: CC
authors.lastname: Wan
authors.affiliation: Department of Hematology, Guangdong General Hospital/Guangdong Academy of Medical Sciences, Guangzhou 510080, Guangdong Province, China.
authors.forename: Sui-Jing
authors.initials: SJ
authors.lastname: Wu
authors.affiliation: Department of Hematology, Guangdong General Hospital/Guangdong Academy of Medical Sciences, Guangzhou 510080, Guangdong Province, China.
authors.forename: Li-Ye
authors.initials: LY
authors.lastname: Zhong
authors.affiliation: Department of Hematology, Guangdong General Hospital/Guangdong Academy of Medical Sciences, Guangzhou 510080, Guangdong Province, China.
authors.forename: Ze-Sheng
authors.initials: ZS
authors.lastname: Lu
authors.affiliation: Department of Hematology, Guangdong General Hospital/Guangdong Academy of Medical Sciences, Guangzhou 510080, Guangdong Province, China.
authors.forename: Xiao-Li
authors.initials: XL
authors.lastname: Zou
authors.affiliation: Department of Hematology, Guangdong General Hospital/Guangdong Academy of Medical Sciences, Guangzhou 510080, Guangdong Province, China.
authors.forename: Xin
authors.initials: X
authors.lastname: DU
mesh_terms: D000293:Adolescent; D000328:Adult; D000380:Agranulocytosis; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D017338:Cladribine / Q000627:therapeutic use; D003561:Cytarabine / Q000627:therapeutic use; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D012074:Remission Induction; D013921:Thrombocytopenia; D019772:Topotecan / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D003561:Cytarabine; D016179:Granulocyte Colony-Stimulating Factor; D017338:Cladribine; D019772:Topotecan