PMID- 38256031
OWN - NLM
STAT- MEDLINE
DCOM- 20240124
LR  - 20240201
IS  - 1422-0067 (Electronic)
IS  - 1422-0067 (Linking)
VI  - 25
IP  - 2
DP  - 2024 Jan 12
TI  - Clofarabine Preconditioning followed by Allogeneic Transplant Using TBI and 
      Post-Transplant Cyclophosphamide for Relapsed Refractory Leukemia.
LID - 10.3390/ijms25020957 [doi]
LID - 957
AB  - Acute myeloid leukemia patients with induction failure or relapsed refractory 
      disease have minimal chance of achieving remission with subsequent treatments. 
      Several trials have shown the feasibility of clofarabine-based conditioning in 
      allogeneic stem cell transplants (allo-HSCT) for non-remission AML patients. 
      Pre-transplant conditioning with clofarabine followed by reduced-intensity 
      allo-HSCT has also demonstrated a potential benefit in those patients with human 
      leukocyte antigen (HLA)-identical donors, but it is not commonly used in 
      haploidentical and mismatched transplants. In this case report, we describe our 
      experience of seven cases of non-remission AML who received clofarabine 
      preconditioning followed by an allo-HSCT with PTCy. The 2-year overall survival 
      and disease-free survival was 83.3% (95% confidence interval (CI): 27.3-97.9%) 
      and 85.7% (95% CI: 33.4-97.9%). Median days of neutrophil and platelet recovery 
      were 16 (range of 13-23) and 28 (range of 17-75), respectively. The cumulative 
      incidence of grade II-IV acute graft-versus-host disease (GVHD) at day 100 and 
      chronic GVHD at 1-year showed 28.6% (95% CI: 8-74.2%) and 28.6% (95% CI: 
      3-63.9%), respectively. The two-year relapse rate was 14.3% (95% CI: 2.14-66.6%). 
      One-year GVHD-free relapse-free survival (GFRS) at 1-year was 71.4% (95% CI: 
      25.8-92%). Our patients showed successful outcomes with clofarabine 
      preconditioning to reduce the leukemic burden at the pre-transplant period 
      followed by PTCy to reduce GVHD resulting in lower relapsed rate and better GFRS 
      in these patients.
FAU - Naik, Seema
AU  - Naik S
AUID- ORCID: 0000-0002-9859-151X
AD  - Department of Medicine, Penn State Cancer Institute, 500 University Dr. Hershey, 
      Hershey, PA 17033, USA.
FAU - Rakszawski, Kevin
AU  - Rakszawski K
AUID- ORCID: 0000-0001-7441-9531
AD  - Department of Medicine, Penn State Cancer Institute, 500 University Dr. Hershey, 
      Hershey, PA 17033, USA.
FAU - Zheng, Hong
AU  - Zheng H
AD  - Department of Medicine, Penn State Cancer Institute, 500 University Dr. Hershey, 
      Hershey, PA 17033, USA.
FAU - Claxton, David
AU  - Claxton D
AUID- ORCID: 0000-0001-9209-2405
AD  - Department of Medicine, Penn State Cancer Institute, 500 University Dr. Hershey, 
      Hershey, PA 17033, USA.
FAU - Minagawa, Kentaro
AU  - Minagawa K
AD  - Department of Medicine, Penn State Cancer Institute, 500 University Dr. Hershey, 
      Hershey, PA 17033, USA.
FAU - Mineishi, Shin
AU  - Mineishi S
AD  - Department of Medicine, Penn State Cancer Institute, 500 University Dr. Hershey, 
      Hershey, PA 17033, USA.
LA  - eng
PT  - Case Reports
DEP - 20240112
PL  - Switzerland
TA  - Int J Mol Sci
JT  - International journal of molecular sciences
JID - 101092791
RN  - 762RDY0Y2H (Clofarabine)
RN  - 8N3DW7272P (Cyclophosphamide)
SB  - IM
MH  - Humans
MH  - Clofarabine
MH  - Cyclophosphamide/therapeutic use
MH  - *Graft vs Host Disease/etiology/prevention & control
MH  - *Leukemia, Myeloid, Acute/therapy
MH  - Allografts
PMC - PMC10815844
OTO - NOTNLM
OT  - AML: acute myeloid leukemia
OT  - Allo-HSCT: allogeneic transplant
OT  - Clo: clofarabine
OT  - PTCy: post-transplant cyclophosphamide
COIS- S.N. Advisory member board ADC therapeutics, Janssen. K.R. Advisory member board 
      Seagen, Incyte, Janssen and Speakers Bureau Seagen, AstraZeneca. All other 
      authors declare that they have no conflicts of interest.
EDAT- 2024/01/23 06:43
MHDA- 2024/01/24 06:43
PMCR- 2024/01/12
CRDT- 2024/01/23 01:12
PHST- 2023/12/01 00:00 [received]
PHST- 2024/01/08 00:00 [revised]
PHST- 2024/01/08 00:00 [accepted]
PHST- 2024/01/24 06:43 [medline]
PHST- 2024/01/23 06:43 [pubmed]
PHST- 2024/01/23 01:12 [entrez]
PHST- 2024/01/12 00:00 [pmc-release]
AID - ijms25020957 [pii]
AID - ijms-25-00957 [pii]
AID - 10.3390/ijms25020957 [doi]
PST - epublish
SO  - Int J Mol Sci. 2024 Jan 12;25(2):957. doi: 10.3390/ijms25020957.