Clofarabine as a bridge to hematopoietic stem cell transplant

Thomas, Christan M.; Ippoliti, Cindy; Roboz, Gail J.; Feldman, Eric J.; Savva, Dimitrios; James, Sara St.; Besien, Koen van

doi:10.1080/10428194.2016.1185784

Cited by 4 publications

(3 citation statements)

References 12 publications

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“…The patients tolerated conditioning well with one-year overall survival of 48% in this highly aggressive AML population, and one-year transplant-related mortality was 8%. Other groups showed similar results [10][11][12][13]. Thus, clofarabine used as a bridge to allo-HSCT to reduce disease burden was well tolerated in high-risk refractory AML patients with acceptable toxicities.…”

Section: Discussionmentioning

confidence: 63%

“…The sequential treatment with chemotherapy and reduced-intensity conditioning for allo-HSCT has shown a potential benefit in relapsed and refractory patients [7,8], where the induction chemotherapy was given just before conditioning and patients received allo-HSCT at nadir. More recently, clofarabine has been used for preconditioning [9][10][11][12][13]. However, clofarabine is less frequently used in haploidentical and mismatched transplants.…”

Section: Introductionmentioning

confidence: 99%

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Clofarabine Preconditioning followed by Allogeneic Transplant Using TBI and Post-Transplant Cyclophosphamide for Relapsed Refractory Leukemia

Naik,

Rakszawski,

Zheng

et al. 2024

IJMS

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Acute myeloid leukemia patients with induction failure or relapsed refractory disease have minimal chance of achieving remission with subsequent treatments. Several trials have shown the feasibility of clofarabine-based conditioning in allogeneic stem cell transplants (allo-HSCT) for non-remission AML patients. Pre-transplant conditioning with clofarabine followed by reduced-intensity allo-HSCT has also demonstrated a potential benefit in those patients with human leukocyte antigen (HLA)-identical donors, but it is not commonly used in haploidentical and mismatched transplants. In this case report, we describe our experience of seven cases of non-remission AML who received clofarabine preconditioning followed by an allo-HSCT with PTCy. The 2-year overall survival and disease-free survival was 83.3% (95% confidence interval (CI): 27.3–97.9%) and 85.7% (95% CI: 33.4–97.9%). Median days of neutrophil and platelet recovery were 16 (range of 13–23) and 28 (range of 17–75), respectively. The cumulative incidence of grade II-IV acute graft-versus-host disease (GVHD) at day 100 and chronic GVHD at 1-year showed 28.6% (95% CI: 8–74.2%) and 28.6% (95% CI: 3–63.9%), respectively. The two-year relapse rate was 14.3% (95% CI: 2.14–66.6%). One-year GVHD-free relapse-free survival (GFRS) at 1-year was 71.4% (95% CI: 25.8–92%). Our patients showed successful outcomes with clofarabine preconditioning to reduce the leukemic burden at the pre-transplant period followed by PTCy to reduce GVHD resulting in lower relapsed rate and better GFRS in these patients.

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Section: Discussionmentioning

confidence: 63%

Section: Introductionmentioning

confidence: 99%

Clofarabine Preconditioning followed by Allogeneic Transplant Using TBI and Post-Transplant Cyclophosphamide for Relapsed Refractory Leukemia

Naik,

Rakszawski,

Zheng

et al. 2024

IJMS

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“…A partir de ese año los pacientes mayores de 40 años recibieron esquemas de intensidad reducida. En los últimos años se incorporó un esquema orientado a pacientes con LMA refractaria usando clofarabina como puente al trasplante 8 .…”

Section: Trasplante Hematopoyético: Donante Y Pacienteunclassified

Resultados a largo plazo de una cohorte chilena: la edad del paciente no incide en el resultado del trasplante alogénico de precursores hematopoyéticos para leucemia mieloide aguda

et al. 2021

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Age does not affect the outcome of allogeneic hematopoietic precursor transplantation for acute myeloid leukemia Background: In our country, transplantation centers differ in the age limit for allogeneic hematopoietic transplantation (ALOHT). In our program, transplants with age-adjusted conditioning are performed in patients until 70 years old. Currently more than 60% of ALOHT reported to the Center for International Bone Marrow Transplantation Research (CIBMTR) are performed in patients older than 40 years. Aim: To report our experience with ALOHT in acute myelogenous leukemia (AML), analyzing patient age at transplantation in different periods and transplant results in different age groups. Material and Methods: A retrospective analysis of the database of adult hematopoietic transplants in AML patients was performed. Demographic data, disease characteristics, transplant data, survival and relapse times, and mortality were collected. Results: In our program, 1030 transplants were performed in adults and 119 ALOHT were performed in AML patients, between 1990 and 2020. The median age of patients in all periods was 41 years, (range 16-69). The median age was 33 and 45 years, in the periods 1990-2000 and 2000-2020 respectively (p < 0.01). Seventy-eight patients received myeloablative conditioning (median age 44 years) and 41 reduced intensity conditioning (median age 53 years). Five-year overall survival was 44.6% (confidence intervals . Non relapse mortality of all periods was 19% (CI 17 -40%) and relapse rate was 17 % . No difference in five years overall survival among patients younger than 40, 41 to 50 and over 51 years was observed. Conclusions: Overall Survival, non-relapse mortality and relapse rate were similar in younger and older patients in our program and similar to those previously reported in other centers.

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Second allogeneic transplantation: ever? never? or sometimes

Mayer

Besien

2016

Leukemia & Lymphoma

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Clofarabine as a bridge to hematopoietic stem cell transplant

Cited by 4 publications

References 12 publications

Clofarabine Preconditioning followed by Allogeneic Transplant Using TBI and Post-Transplant Cyclophosphamide for Relapsed Refractory Leukemia

Clofarabine Preconditioning followed by Allogeneic Transplant Using TBI and Post-Transplant Cyclophosphamide for Relapsed Refractory Leukemia

Resultados a largo plazo de una cohorte chilena: la edad del paciente no incide en el resultado del trasplante alogénico de precursores hematopoyéticos para leucemia mieloide aguda

Second allogeneic transplantation: ever? never? or sometimes

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