Prolonged myelosuppression with clofarabine in the treatment of patients with relapsed or refractory, aggressive non-Hodgkin lymphoma. Leuk Lymphoma 2009 Mar;50(3):349-56
Date
03/06/2009Pubmed ID
19263294Pubmed Central ID
PMC3695225DOI
10.1080/10428190902730227Scopus ID
2-s2.0-67650876387 (requires institutional sign-in at Scopus site) 5 CitationsAbstract
We evaluated the safety and efficacy of the purine nucleoside analogue, clofarabine, in patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) and mantle cell lymphoma (MCL). Six patients with DLBCL (n = 5) or MCL (n = 1) and a median age of 68 years were treated with 40 mg/m(2) clofarabine IV over 2 h for 5 days, repeated every 28 days, for 1-2 cycles. The overall response rate was 50% (complete response = 1, complete response unconfirmed = 1, partial response = 1). Median progression-free survival was 3.5 months (range 1.5-10 months) and the median overall survival was 7.8 months (range 3-31 months). Grade 3-4 neutropenia and thrombocytopenia was universal, with a median of 34 (range 19-55) and 77 (range 0-275) days required for neutrophil and platelet recovery. Grade 3 non-hematologic toxicities included transaminitis, febrile neutropenia, non-neutropenic infections and orthostatic hypotension. Further accrual to the study was terminated due to prolonged Grade 3-4 myelosuppression and orthostatic hypotension in five of six patients. Clofarabine exhibits evidence of single agent activity in relapsed or refractory DLBCL. However, further study with novel administration schedules that maintain this efficacy and limit toxicity is warranted.
Author List
Blum KA, Hamadani M, Phillips GS, Lozanski G, Johnson AJ, Lucas DM, Smith LL, Baiocchi R, Lin TS, Porcu P, Devine SM, Byrd JCAuthor
Mehdi H. Hamadani MD Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Adenine NucleotidesAged
Arabinonucleosides
Female
Hematopoiesis
Humans
Kinetics
Lymphoma, Large B-Cell, Diffuse
Lymphoma, Mantle-Cell
Lymphoma, Non-Hodgkin
Male
Middle Aged
Myeloablative Agonists
Neutropenia
Remission Induction
Salvage Therapy
Survival Analysis
Thrombocytopenia
