Clofarabine Does Not Negatively Impact the Outcomes of Patients With Acute Myeloid Leukemia Undergoing Allogeneic Stem Cell Transplantation

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• 作者：Michael S. Mathisen ; Hagop Kantarjian ; Elias Jabbour ; Guillermo Garcia-Manero ; Farhad Ravandi ; Stefan Faderl ; Gautam Borthakur ; Jorge E. Cortes ; Alfonso Quintá ; s-Cardama ; ^{aquintas@mdanderson.org}
• 关键词：Acute myeloid leukemia ; Allogeneic stem cell transplantation ; Clofarabine ; Hepatotoxicity ; Venoocclusive disease
• 刊名：Clinical Lymphoma Myeloma and Leukemia
• 出版年：2013
• 出版时间：April, 2013
• 年：2013
• 卷：13
• 期：2
• 页码：139-143
• 全文大小：292 K

文摘

Background

Clofarabine is actively being investigated as a component of frontline chemotherapy for acute myeloid leukemia (AML). Hepatotoxicity is 1 of the primary adverse events associated with clofarabine and can occasionally can include severe venoocclusive disease (VOD).

Patients and Methods

Many patients with AML undergo allogeneic stem cell transplantation (allo-SCT), a procedure that is also associated with hepatotoxicity. We identified AML patients undergoing allo-SCT and stratified them according to whether they received clofarabine-containing (clofarabine, idarubicin, and cytarabine [CIA]) or non-clofarabine-containing cytarabine-based induction/consolidation chemotherapy (idarubicin and cytarabine [ara-C] [IA]). We compared both groups for differences in posttransplantation hepatotoxicity, VOD, and other transplantation outcomes. Forty-two patients were identified (20 receiving CIA and 22 receiving IA). Patient and transplant characteristics were similar. All patients receiving clofarabine-based treatment received CIA within 2.5 months of their allo-SCT.

Results

There was no difference in the incidence of VOD in the 30 days after transplantation (0 CIA, 1 IA; P = 1.0). Rates of grade 3/4 hepatotoxicity also did not differ between groups. Acute graft-versus-host disease (GVHD), early relapse, and survival were also not significantly different.

Conclusions

We conclude that clofarabine-containing chemotherapy does not adversely impact the outcome of allo-SCT. Specifically, it does not predispose patients to an increased risk of hepatotoxicity, VOD, GVHD, or relapse.