Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Rabitsch, W; Böhm, A; Bojic, M; Schellongowski, P; Wöhrer, S; Sliwa, T; Keil, F; Worel, N; Greinix, H; Hauswirth, A; Kalhs, P; Jaeger, U; Valent, P; Sperr, WR.
Clofarabine/cyclophosphamide for debulking before stem cell transplantation.
Eur J Clin Invest. 2014; 44(8):775-783
Doi: 10.1111/eci.12294
Web of Science
PubMed
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- Co-Autor*innen der Med Uni Graz
- Greinix Hildegard
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- Abstract:
- Allogeneic haematopoietic stem cell transplantation (HSCT) is the only curative rescue therapy for patients (pts) with chemotherapy-refractory acute leukaemia. Disease control prior to HSCT is essential for long-term disease-free survival after HSCT. We have retrospectively analysed the outcome of 20 pts aged 21-64 years with refractory leukaemia (acute myeloid leukaemia, n = 16; acute lymphatic leukaemia, n = 4) who received debulking therapy with clofarabine (10 mg/m², days 1-4) and cyclophosphamide (200 mg/m², days 1-4; ClofCy) prior to HSCT. Clofarabine/cyclophosphamide (1-4 cycles) was well tolerated and resulted in a substantial reduction of leukaemic cells in all pts. HSCT was performed in 15 of 20 pts. After HSCT (myeloablative, n = 9; dose-reduced, n = 6), all pts showed engraftment and full donor chimerism (related donors, n = 4 or unrelated donors, n = 11) and all pts achieved complete haematologic remission (CR). The median survival after HSCT is 531 days (range: 48-1462 days), and six pts are still alive after a median of 1245 days. Seven pts died after they had relapsed between days +152 and +1496. One patient died from acute graft-versus-host disease (day +48) and one from systemic fungal infection (day +87). Clofarabine/cyclophosphamide is a novel effective treatment approach for pts with chemotherapy-refractory acute leukaemia prior to HSCT. Whether this novel debulking protocol leads to improved long-term outcome in pts with refractory leukaemias remains to be determined in forthcoming clinical studies. © 2014 Stichting European Society for Clinical Investigation Journal Foundation.
- Find related publications in this database (using NLM MeSH Indexing)
- Adenine Nucleotides - administration & dosage
- Adult -
- Antineoplastic Combined Chemotherapy Protocols - therapeutic use
- Arabinonucleosides - administration & dosage
- Clofarabine -
- Cyclophosphamide - administration & dosage
- Drug Administration Schedule -
- Female -
- Graft vs Host Disease - etiology
- Graft vs Host Disease - mortality
- Hematopoietic Stem Cell Transplantation - adverse effects
- Hematopoietic Stem Cell Transplantation - methods
- Hematopoietic Stem Cell Transplantation - mortality
- Humans -
- Leukemia, Myeloid, Acute - mortality
- Leukemia, Myeloid, Acute - therapy
- Male -
- Middle Aged -
- Precursor Cell Lymphoblastic Leukemia-Lymphoma - mortality
- Precursor Cell Lymphoblastic Leukemia-Lymphoma - therapy
- Retrospective Studies -
- Transplantation, Homologous -
- Treatment Outcome -
- Young Adult -
- Find related publications in this database (Keywords)
- Debulking
- haematopoietic stem cell transplantation
- refractory leukaemia
- survival