Blood online
Home About Blood Authors Subscriptions Permission Advertising Public Access contact us
 

 
Advanced
Current Issue
First Edition
Future Articles
Archives
Submit to Blood
Search
American Society of Hematology
Meeting Abstracts
Email Alerts
Prepublished online as a Blood First Edition Paper on June 5, 2003; DOI 10.1182/blood-2003-03-0925.

This Article
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
2003-03-0925v1
102/7/2379    most recent
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Right arrow Rights and Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Kantarjian, H. M
Right arrow Articles by Freireich, E. J
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Kantarjian, H. M
Right arrow Articles by Freireich, E. J
Related Collections
Right arrowRelated Article in Blood Online
Social Bookmarking
 Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati  
What's this?

Submitted April 1, 2003
Accepted May 24, 2003

Phase II clinical and pharmacology study of clofarabine in patients with refractory or relapsed acute leukemia

Hagop M 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

Leukemia, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
Experimental Therapeutics, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
ILEX Company, San Antonio, TX, USA
Leukemia, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA; Experimental Therapeutics, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA

* Corresponding author; email: hkantarj{at}mdanderson.org.

In a phase II 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 clofarabine 40 mg/m2 IV over 1 hour daily x 5, every 3 to 6 weeks. Twenty patients (32%) achieved complete response (CR), 1 had a partial response (PR), and 9 (15%) had CR but without platelet recovery (CR-p), for an overall response rate of 48%. In AML, responses were noted in 2/11 patients (18%) in first salvage with short first CR (<=12 months), in 7/8 (87%) patients with longer first CR, and in 8/12 patients (67%) in second or subsequent salvage. Responses were observed in 4/8 patients with high-risk MDS (50%), in 7/11 (64%) with CML-BP, and in 2/12 (17%) 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 to non-responders (median 18 vs 10 µM; p=0.03). This increased only in responders (median, 1.8-fold; p=0.008) after the second clofarabine infusion. In summary, clofarabine is active in acute leukemias and MDS; cellular pharmacokinetics may have prognostic significance.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati 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:


Home page
Clin. Cancer Res.Home page
C. Seedhouse, M. Grundy, S. Shang, J. Ronan, H. Pimblett, N. Russell, and M. Pallis
Impaired S-Phase Arrest in Acute Myeloid Leukemia Cells with a FLT3 Internal Tandem Duplication Treated with Clofarabine
Clin. Cancer Res., December 1, 2009; 15(23): 7291 - 7298.
[Abstract] [Full Text] [PDF]


Home page
JCOHome page
S. Jeha, B. Razzouk, M. Rytting, S. Rheingold, E. Albano, R. Kadota, L. Luchtman-Jones, L. Bomgaars, P. Gaynon, S. Goldman, et al.
Phase II Study of Clofarabine in Pediatric Patients With Refractory or Relapsed Acute Myeloid Leukemia
J. Clin. Oncol., September 10, 2009; 27(26): 4392 - 4397.
[Abstract] [Full Text] [PDF]


Home page
BloodHome page
R. M. Stone
How I treat patients with myelodysplastic syndromes
Blood, June 18, 2009; 113(25): 6296 - 6303.
[Full Text] [PDF]


Home page
Anticancer ResHome page
J. STYCZYNSKI, L. GIL, K. DERWICH, J. WACHOWIAK, W. BALWIERZ, W. BADOWSKA, M. KRAWCZUK-RYBAK, M. MATYSIAK, M. WIECZOREK, A. BALCERSKA, et al.
Comparison of Clofarabine Activity in Childhood and Adult Acute Leukemia: Individual Tumor Response Study
Anticancer Res, May 1, 2009; 29(5): 1643 - 1650.
[Abstract] [Full Text] [PDF]


Home page
The OncologistHome page
J. Laubach and A. V. Rao
Current and Emerging Strategies for the Management of Acute Myeloid Leukemia in the Elderly
Oncologist, October 1, 2008; 13(10): 1097 - 1108.
[Abstract] [Full Text] [PDF]


Home page
BloodHome page
S. Faderl, F. Ravandi, X. Huang, G. Garcia-Manero, A. Ferrajoli, Z. Estrov, G. Borthakur, S. Verstovsek, D. A. Thomas, M. Kwari, et al.
A randomized study of clofarabine versus clofarabine plus low-dose cytarabine as front-line therapy for patients aged 60 years and older with acute myeloid leukemia and high-risk myelodysplastic syndrome
Blood, September 1, 2008; 112(5): 1638 - 1645.
[Abstract] [Full Text] [PDF]


Home page
ASH Education BookHome page
S. M. Horwitz
Novel Therapies and Role of Transplant in the Treatment of Peripheral T-Cell Lymphomas
Hematology, January 1, 2008; 2008(1): 289 - 296.
[Abstract] [Full Text] [PDF]


Home page
The OncologistHome page
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]


Home page
BloodHome page
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]


Home page
BloodHome page
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]


Home page
ASH Education BookHome page
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]


Home page
Clin. Cancer Res.Home page
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]


Home page
BloodHome page
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]


Home page
JCOHome page
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]


Home page
Mayo Clin Proc.Home page
E. J. Jabbour, E. Estey, and H. M. Kantarjian
Adult Acute Myeloid Leukemia
Mayo Clin. Proc., February 1, 2006; 81(2): 247 - 260.
[Abstract] [Full Text] [PDF]


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


Home page
Mol. Pharmacol.Home page
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]


Home page
Molecular Cancer TherapeuticsHome page
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]


Home page
Mayo Clin Proc.Home page
E. J. Jabbour, S. Faderl, and H. M. Kantarjian
Adult Acute Lymphoblastic Leukemia
Mayo Clin. Proc., November 1, 2005; 80(11): 1517 - 1527.
[Abstract] [PDF]


Home page
Clin. Cancer Res.Home page
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]


Home page
Drug Metab. Dispos.Home page
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]


Home page
BloodHome page
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]


Home page
ASH Education BookHome page
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]


Home page
J Clin PharmacolHome page
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]


Home page
BloodHome page
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]


Home page
Clin. Cancer Res.Home page
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]



 click for free articles
home about blood authors subscriptions permissions advertising public access contact us
  Copyright © 2003 by American Society of Hematology         Online ISSN: 1528-0020