- Author:
Xiao-Mei CHEN
1
;
Jian-Yu WENG
2
;
Cheng-Xin DENG
3
;
Yu-Lian WANG
3
;
Zhi CHAO
3
;
Pei-Long LAI
3
;
Min-Ming LI
3
;
Peng-Jun LIAO
3
;
Xin HUANG
3
;
Wei LING
3
;
Chang-Chun WAN
3
;
Sui-Jing WU
3
;
Li-Ye ZHONG
3
;
Ze-Sheng LU
3
;
Xiao-Li ZOU
3
;
Xin DU
3
Author Information
- Publication Type:Journal Article
- MeSH: Adolescent; Adult; Agranulocytosis; Antineoplastic Combined Chemotherapy Protocols; therapeutic use; Cladribine; therapeutic use; Cytarabine; therapeutic use; Female; Granulocyte Colony-Stimulating Factor; therapeutic use; Humans; Leukemia, Myeloid, Acute; drug therapy; Male; Middle Aged; Remission Induction; Thrombocytopenia; Topotecan; therapeutic use; Young Adult
- From: Journal of Experimental Hematology 2016;24(2):399-404
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVETo explore the clinical efficacy and toxicity of CLAT protocol (cladribine, cytarabine and topotecan) for treating patients with refractory acute myeloid leukemia (R-AML).
METHODSA total of 18 patients with R-AML (median age 37 years, range 18 to 58 years; male n = 16, female n = 2) were treated with CLAT protocol, which consisted of cladribine 5 mg/m(2)/d, i.v. on days 1-5, cytarabine 1.5 g/m(2)/d, i.v. on days 1-5, topotecan 1.25 mg/m(2)/d, i.v. on days 1-5 and G-CSF 300 µg/d subcutaneous injection on day 6 until neutrophile granulocyte recovery.
RESULTSOut of 18 patients 2 died of severe infection before the assessment. Among 16 evaluated patients, 10 (55.6%) achieved complete remission (CR), and 2 (11.1%) achieved partial remission (PR), the overall response rate was 66.7%, the rest 4 patients did not respond (NR). The median overall survival time and DFS for the CR patients was 9.5 months (95%CI: 6.7-16.64) and 9.5 months (95%CI: 6.1-16.7) respectively. The 1 year OS and DFS rates were 45% and 46.9%, respectively. All patients developed grade 4 of granulocytopenia and thrombocytopenia, the median duration was 13 (range 2 to 21) days and 12 days (range 2 to 21), respectively, all patients developed infection, 2 patients died of severe infection. The most common non-hematological side effects included nausea, vomiting, diarrhoea, rash, aminotransferase or bilirubin elevation and were grade 1 to 2.
CONCLUSIONThe CLAT protocol seems to have promising for the treatment of refractory AML patients, and patients well tolerated. This CLAT protocol offers an alternative treatment for R-AML patients who received severe intensive treatment, especially with anthracycline-containing chemotherapy.