The use of higher dose clofarabine in adults with relapsed acute lymphoblastic leukemia

✍ Scribed by Bradley A. McGregor; Alexander W. Brown; Michael B. Osswald; Michael R. Savona

• Publisher: John Wiley and Sons
• Year: 2009
• Tongue: English
• Weight: 65 KB
• Volume: 84
• Category: Article
• ISSN: 0361-8609
• DOI: 10.1002/ajh.21365

✦ Synopsis

Abstract

The standard dose of clofarabine is 52 mg/m^2^ for pediatrics and 40 mg/m^2^ in adults. Clofarabine dosed at 52 mg/m^2^ was used in adult patients with refractory ALL to maximize response before allo‐HSCT. All patients had a significant response to therapy. Published pharmacokinetic analysis revealed no difference in peak plasma or intracellular concentrations at clofarabine dosed above 40 mg/m^2^, yet inhibition of replication in leukemia cells was only sustained over 24 hr at 55 mg/m^2^. Despite this, there have been no reports of high dose clofarabine used in this setting. Our experience implies that there may be a niche role for clofarabine in reducing disease burden before allo‐HSCT for adults with relapsed ALL. Am. J. Hematol., 2009. Published 2009 Wiley‐Liss, Inc.