Cladribine in the Treatment of Acute Myeloid Leukemia: A Single-Institution Experience
Cladribine in the Treatment of Acute Myeloid Leukemia: A Single-Institution Experience
复制标题
DOI：
10.3816/clm.2009.n.058
复制
发表时间：
2009-08-01
期刊：
影响因子：
--
通讯作者：
Abboud, Camille N.
中科院分区：
文献类型：
--
作者：
Martin, Mike G.;Welch, John S.;Abboud, Camille N.
工作背景：尽管在新疗法、支持性治疗和缓解后治疗方面取得了进展，但高危和老年患者以及复发/难治性急性髓性白血病（AML）患者的结局仍然很差。通过优化常规化疗可能仍有改进的空间。患者和方法：通过药房数据库检索，我们确定了所有在华盛顿大学接受克拉屈滨方案治疗的AML患者。结果如下：24例患者接受了2种基于克拉屈滨的治疗方案：CLAG（克拉屈滨[5 mg/m2（1-5天）]，阿糖胞苷[2 g/m2（1-5天）]和粒细胞集落刺激因子[G-CSF; 300 μ g皮下（s.c.）第0-5天]）和CLAM（克拉屈滨[5 mg/m2（2）第1-5天]、阿糖胞苷[2 g/m2（2）第1-5天]、G-CSIF [300 mg s.c.第0-5天]和米托蒽醌[10 mg/m2（2）第1-3天]）。53%的诱导化疗患者和44%的挽救化疗患者达到完全缓解。该方案耐受性良好，髓外毒性最小。结论：这些数据表明，克拉屈滨为基础的方案，应进一步探讨在挽救和一线设置，并可能提供一个有吸引力的骨干上添加新的疗法。
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. Patients and 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/m(2) days 1-5], cytarabine [2 g/m(2) days 1-5] and granulocyte colony-stimulating factor [G-CSF; 300 mu g subcutaneously (s.c.) days 0-5]) and CLAM (cladribine [5 mg/m(2) days 1-5], cytarabine [2 g/m(2) days 1-5], G-CSIF [300 mg s.c. days 0-5] and mitoxantrone [10 mg/m(2) 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. Conclusion: 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.