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A clofarabine-based bridging regimen in patients with relapsed ALL and persistent minimal residual disease (MRD). Bone Marrow Transplant 2014 Mar;49(3):440-2

Date

12/10/2013

Pubmed ID

24317126

DOI

10.1038/bmt.2013.195

Abstract

In patients with relapsed ALL, minimal residual disease (MRD) identified prior to allogeneic hematopoietic cell transplantation (HCT) is a strong predictor of relapse. We report our experience using a combination of reduced-dosing clofarabine, CY and etoposide as a 'bridge' to HCT in eight patients with high risk or relapsed ALL and pre-HCT MRD. All patients had detectable MRD (>0.01%, flow cytometry) at the start of therapy with all eight achieving MRD reduction following one cycle. The regimen was well tolerated with seven grade 3/4 toxicities occurring among four of the eight patients. Five patients (62.5%) are alive, one died from relapse (12.5%) and two from transplant-related mortality (25%). The combination of reduced-dose clofarabine, CY and etoposide as bridging therapy appears to be well tolerated in patients with relapsed ALL and is effective in reducing pre-HCT MRD.

Author List

Gossai N, Verneris MR, Karras NA, Gorman MF, Patel NJ, Burke MJ

Author

Michael James Burke MD Professor in the Pediatrics department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adenine Nucleotides
Adolescent
Antimetabolites, Antineoplastic
Arabinonucleosides
Child
Child, Preschool
Cyclophosphamide
Etoposide
Hematopoietic Stem Cell Transplantation
Humans
Infant
Neoplasm Recurrence, Local
Neoplasm, Residual
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Probability
Remission Induction
Time Factors
Treatment Outcome
Young Adult
jenkins-FCD Prod-482 91ad8a360b6da540234915ea01ff80e38bfdb40a