|
|
Prepublished online as a Blood First Edition Paper on June 5, 2003; DOI 10.1182/blood-2003-03-0925.
Previous Article | Table of Contents | Next Article 
Blood, 1 October 2003, Vol. 102, No. 7, pp. 2379-2386
CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS
Phase 2 clinical and pharmacologic study of clofarabine in patients with refractory or relapsed acute leukemia
Hagop Kantarjian,
Varsha Gandhi,
Jorge Cortes,
Srdan Verstovsek,
Min Du,
Guillermo Garcia-Manero,
Francis Giles,
Stefan Faderl,
Susan O'Brien,
Sima Jeha,
Jan Davis,
Zeev Shaked,
Adam Craig,
Michael Keating,
William Plunkett, and
Emil J Freireich
From the Departments of Leukemia and Experimental Therapeutics, MD Anderson Cancer Center, Houston, TX; and ILEX Company, San Antonio, TX.
In a phase 2 study, 62 patients with relapsed and refractory acute myeloid leukemia (AML; n = 31), myelodysplastic syndrome (MDS; n = 8), chronic myeloid leukemia in blastic phase (CMLBP; n = 11), and acute lymphocytic leukemia (ALL; n = 12) received 40 mg/m2 clofarabine intravenously over 1 hour daily for 5 days, every 3 to 6 weeks. Twenty patients (32%) achieved complete response (CR), 1 had a partial response (PR), and 9 (15%) achieved CR but without platelet recovery (CRp), for an overall response rate of 48%. In AML, responses were noted in 2 (18%) of 11 patients in first salvage with short first CR ( 12 months), in 7 (87%) of 8 patients with longer first CR, and in 8 (67%) of 12 patients in second or subsequent salvage. Responses were observed in 4 of 8 patients with high-risk MDS (50%), in 7 (64%) of 11 with CML-BP, and in 2 (17%) of 12 with ALL. Severe reversible liver dysfunction was noted in 15% to 25%. After the first clofarabine infusion, responders accumulated more clofarabine triphosphate in blasts compared with nonresponders (median 18 vs 10 µM; P = .03). This increased only in responders (median, 1.8-fold; P = .008) after the second clofarabine infusion. In summary, clofarabine is active in acute leukemias and MDS; cellular pharmacokinetics may have prognostic significance. (Blood. 2003;102:2379-2386)

CiteULike Connotea Del.icio.us Digg Reddit Technorati What's this?
Related Article in Blood Online:
-
PNAs for AML
- Mark R. Litzow
Blood 2003 102: 2315.
[Full Text]
[PDF]
This article has been cited by other articles:

|
 |

|
 |
 
M. E. King and J. M. Rowe
Recent Developments in Acute Myelogenous Leukemia Therapy
Oncologist,
October 1, 2007;
12(suppl_2):
14 - 21.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
J. E. Karp, R. M. Ricklis, K. Balakrishnan, J. Briel, J. Greer, S. D. Gore, B. D. Smith, M. A. McDevitt, H. Carraway, M. J. Levis, et al.
A phase 1 clinical-laboratory study of clofarabine followed by cyclophosphamide for adults with refractory acute leukemias
Blood,
September 15, 2007;
110(6):
1762 - 1769.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
F. R. Appelbaum, D. Rosenblum, R. J. Arceci, W. L. Carroll, P. P. Breitfeld, S. J. Forman, R. A. Larson, S. J. Lee, S. B. Murphy, S. O'Brien, et al.
End points to establish the efficacy of new agents in the treatment of acute leukemia
Blood,
March 1, 2007;
109(5):
1810 - 1816.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
H. P. Erba
Prognostic Factors in Elderly Patients with AML and the Implications for Treatment
Hematology,
January 1, 2007;
2007(1):
420 - 428.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
V. Gandhi, W. Plunkett, P. L. Bonate, M. Du, B. Nowak, S. Lerner, and M. J. Keating
Clinical and Pharmacokinetic Study of Clofarabine in Chronic Lymphocytic Leukemia: Strategy for Treatment.
Clin. Cancer Res.,
July 1, 2006;
12(13):
4011 - 4017.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
S. Faderl, S. Verstovsek, J. Cortes, F. Ravandi, M. Beran, G. Garcia-Manero, A. Ferrajoli, Z. Estrov, S. O'Brien, C. Koller, et al.
Clofarabine and cytarabine combination as induction therapy for acute myeloid leukemia (AML) in patients 50 years of age or older
Blood,
July 1, 2006;
108(1):
45 - 51.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
S. Jeha, P. S. Gaynon, B. I. Razzouk, J. Franklin, R. Kadota, V. Shen, L. Luchtman-Jones, M. Rytting, L. R. Bomgaars, S. Rheingold, et al.
Phase II Study of Clofarabine in Pediatric Patients With Refractory or Relapsed Acute Lymphoblastic Leukemia
J. Clin. Oncol.,
April 20, 2006;
24(12):
1917 - 1923.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
C. A. Schiffer
Clinical Issues in the Management of Patients with Myelodysplasia
Hematology,
January 1, 2006;
2006(1):
205 - 210.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
K. M. King, V. L. Damaraju, M. F. Vickers, S. Y. Yao, T. Lang, T. E. Tackaberry, D. A. Mowles, A. M. L. Ng, J. D. Young, and C. E. Cass
A Comparison of the Transportability, and Its Role in Cytotoxicity, of Clofarabine, Cladribine, and Fludarabine by Recombinant Human Nucleoside Transporters Produced in Three Model Expression Systems
Mol. Pharmacol.,
January 1, 2006;
69(1):
346 - 353.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
I. Samudio, M. Konopleva, S. Safe, T. McQueen, and M. Andreeff
Guggulsterones induce apoptosis and differentiation in acute myeloid leukemia: identification of isomer-specific antileukemic activities of the pregnadienedione structure
Mol. Cancer Ther.,
December 1, 2005;
4(12):
1982 - 1992.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
S. L. Berg, P. L. Bonate, J. G. Nuchtern, R. Dauser, L. McGuffey, B. Bernacky, and S. M. Blaney
Plasma and Cerebrospinal Fluid Pharmacokinetics of Clofarabine in Nonhuman Primates
Clin. Cancer Res.,
August 15, 2005;
11(16):
5981 - 5983.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
P. L. Bonate, L. Arthaud, J. Stuhler, P. Yerino, R. J. Press, and J. Q. Rose
THE DISTRIBUTION, METABOLISM, AND ELIMINATION OF CLOFARABINE IN RATS
Drug Metab. Dispos.,
June 1, 2005;
33(6):
739 - 748.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
S. Faderl, V. Gandhi, S. O'Brien, P. Bonate, J. Cortes, E. Estey, M. Beran, W. Wierda, G. Garcia-Manero, A. Ferrajoli, et al.
Results of a phase 1-2 study of clofarabine in combination with cytarabine (ara-C) in relapsed and refractory acute leukemias
Blood,
February 1, 2005;
105(3):
940 - 947.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
M. S. Tallman
New Strategies for the Treatment of Acute Myeloid Leukemia Including Antibodies and Other Novel Agents
Hematology,
January 1, 2005;
2005(1):
143 - 150.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
P. L. Bonate, A. Craig, P. Gaynon, V. Gandhi, S. Jeha, R. Kadota, G. N. Lam, W. Plunkett, B. Razzouk, M. Rytting, et al.
Population Pharmacokinetics of Clofarabine, a Second-Generation Nucleoside Analog, in Pediatric Patients With Acute Leukemia
J. Clin. Pharmacol.,
November 1, 2004;
44(11):
1309 - 1322.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
S. Jeha, V. Gandhi, K. W. Chan, L. McDonald, I. Ramirez, R. Madden, M. Rytting, M. Brandt, M. Keating, W. Plunkett, et al.
Clofarabine, a novel nucleoside analog, is active in pediatric patients with advanced leukemia
Blood,
February 1, 2004;
103(3):
784 - 789.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
V. Gandhi, H. Kantarjian, S. Faderl, P. Bonate, M. Du, M. Ayres, M. B. Rios, M. J. Keating, and W. Plunkett
Pharmacokinetics and Pharmacodynamics of Plasma Clofarabine and Cellular Clofarabine Triphosphate in Patients with Acute Leukemias
Clin. Cancer Res.,
December 15, 2003;
9(17):
6335 - 6342.
[Abstract]
[Full Text]
[PDF]
|
 |
|
|
|