Yazarlar : Huguet F, Leguay T, Raffoux E et al

Yayın : Leuk Lymphoma

Yayın Yılı : 2014

Pubmed Linki : http://www.docguide.com/clofarabine-treatment-adult-acute-lymphoid-leukemia-review-article-graall-intergroup?tsid=5

Konu : Lösemi

Literatür İçeriği :  ABSTRACT Clofarabine has been approved by the FDA (2004) and the EMEA (2006) for the treatment of acute lymphoblastic leukemia (ALL) after failure of at least two previous regimens in patients up to 21 years of age at diagnosis. However, it has also been administered in adults. This second-generation purine analog, designed to improve the therapeutic index of both fludarabine and cladribine, displays greater activity on DNA synthesis inhibition and on leukemic cell death; favourable pharmacologic profile; good neurologic tolerance; synergy with alkylating agents. Results in childhood ALL and in adult AML have helped defining its safety profile and management guidelines. More than 100 adults with relapsed/refractory ALL have been reported. Clofarabine as single agent is given at the dose of 40 mg/sqm/day for 5 days. Combination to Cyclophosphamide +/- Etoposide in heavily pre-treated patients can allow remission and act as a bridge to transplant, in T-ALL as in Philadelphia negative and positive B lineage-ALL. In a GRAALL retrospective study of two Clorabine-based regimens, ENDEVOL and VANDEVOL, remission was achieved in roughly 50% of the 55 patients, and 17% to 35% received allogeneic stem cell transplantation in second or further remission. The GRAALL group is thus planning a prospective VANDEVOL trial.

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