Clofarabine does not negatively impact the outcomes of patients with acute myeloid leukemia undergoing allogeneic stem cell transplantation

Michael S. Mathisen, Hagop Kantarjian, Elias Jabbour, Guillermo Garcia-Manero, Farhad Ravandi, Stefan Faderl, Gautam Borthakur, Jorge E. Cortes, Alfonso Quintás-Cardama

Research output: Contribution to journalArticle

Abstract

Background: Clofarabine is actively being investigated as a component of frontline chemotherapy for acute myeloid leukemia (AML). Hepatotoxicity is 1 of the primary adverse events associated with clofarabine and can occasionally can include severe venoocclusive disease (VOD). Patients and Methods: Many patients with AML undergo allogeneic stem cell transplantation (allo-SCT), a procedure that is also associated with hepatotoxicity. We identified AML patients undergoing allo-SCT and stratified them according to whether they received clofarabine-containing (clofarabine, idarubicin, and cytarabine [CIA]) or non-clofarabine-containing cytarabine-based induction/consolidation chemotherapy (idarubicin and cytarabine [ara-C] [IA]). We compared both groups for differences in posttransplantation hepatotoxicity, VOD, and other transplantation outcomes. Forty-two patients were identified (20 receiving CIA and 22 receiving IA). Patient and transplant characteristics were similar. All patients receiving clofarabine-based treatment received CIA within 2.5 months of their allo-SCT. Results: There was no difference in the incidence of VOD in the 30 days after transplantation (0 CIA, 1 IA; P = 1.0). Rates of grade 3/4 hepatotoxicity also did not differ between groups. Acute graft-versus-host disease (GVHD), early relapse, and survival were also not significantly different. Conclusions: We conclude that clofarabine-containing chemotherapy does not adversely impact the outcome of allo-SCT. Specifically, it does not predispose patients to an increased risk of hepatotoxicity, VOD, GVHD, or relapse.

Original languageEnglish (US)
Pages (from-to)139-143
Number of pages5
JournalClinical Lymphoma, Myeloma and Leukemia
Volume13
Issue number2
DOIs
StatePublished - Apr 1 2013
Externally publishedYes

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Stem Cell Transplantation
Acute Myeloid Leukemia
Cytarabine
Idarubicin
Graft vs Host Disease
Transplantation
Consolidation Chemotherapy
clofarabine
Recurrence
Drug Therapy
Induction Chemotherapy
Transplants
Survival
Incidence

Keywords

  • Acute myeloid leukemia
  • Allogeneic stem cell transplantation
  • Clofarabine
  • Hepatotoxicity
  • Venoocclusive disease

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

Cite this

Clofarabine does not negatively impact the outcomes of patients with acute myeloid leukemia undergoing allogeneic stem cell transplantation. / Mathisen, Michael S.; Kantarjian, Hagop; Jabbour, Elias; Garcia-Manero, Guillermo; Ravandi, Farhad; Faderl, Stefan; Borthakur, Gautam; Cortes, Jorge E.; Quintás-Cardama, Alfonso.

In: Clinical Lymphoma, Myeloma and Leukemia, Vol. 13, No. 2, 01.04.2013, p. 139-143.

Research output: Contribution to journalArticle

Mathisen, MS, Kantarjian, H, Jabbour, E, Garcia-Manero, G, Ravandi, F, Faderl, S, Borthakur, G, Cortes, JE & Quintás-Cardama, A 2013, 'Clofarabine does not negatively impact the outcomes of patients with acute myeloid leukemia undergoing allogeneic stem cell transplantation', Clinical Lymphoma, Myeloma and Leukemia, vol. 13, no. 2, pp. 139-143. https://doi.org/10.1016/j.clml.2012.11.004
Mathisen, Michael S. ; Kantarjian, Hagop ; Jabbour, Elias ; Garcia-Manero, Guillermo ; Ravandi, Farhad ; Faderl, Stefan ; Borthakur, Gautam ; Cortes, Jorge E. ; Quintás-Cardama, Alfonso. / Clofarabine does not negatively impact the outcomes of patients with acute myeloid leukemia undergoing allogeneic stem cell transplantation. In: Clinical Lymphoma, Myeloma and Leukemia. 2013 ; Vol. 13, No. 2. pp. 139-143.
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abstract = "Background: Clofarabine is actively being investigated as a component of frontline chemotherapy for acute myeloid leukemia (AML). Hepatotoxicity is 1 of the primary adverse events associated with clofarabine and can occasionally can include severe venoocclusive disease (VOD). Patients and Methods: Many patients with AML undergo allogeneic stem cell transplantation (allo-SCT), a procedure that is also associated with hepatotoxicity. We identified AML patients undergoing allo-SCT and stratified them according to whether they received clofarabine-containing (clofarabine, idarubicin, and cytarabine [CIA]) or non-clofarabine-containing cytarabine-based induction/consolidation chemotherapy (idarubicin and cytarabine [ara-C] [IA]). We compared both groups for differences in posttransplantation hepatotoxicity, VOD, and other transplantation outcomes. Forty-two patients were identified (20 receiving CIA and 22 receiving IA). Patient and transplant characteristics were similar. All patients receiving clofarabine-based treatment received CIA within 2.5 months of their allo-SCT. Results: There was no difference in the incidence of VOD in the 30 days after transplantation (0 CIA, 1 IA; P = 1.0). Rates of grade 3/4 hepatotoxicity also did not differ between groups. Acute graft-versus-host disease (GVHD), early relapse, and survival were also not significantly different. Conclusions: We conclude that clofarabine-containing chemotherapy does not adversely impact the outcome of allo-SCT. Specifically, it does not predispose patients to an increased risk of hepatotoxicity, VOD, GVHD, or relapse.",
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T1 - Clofarabine does not negatively impact the outcomes of patients with acute myeloid leukemia undergoing allogeneic stem cell transplantation

AU - Mathisen, Michael S.

AU - Kantarjian, Hagop

AU - Jabbour, Elias

AU - Garcia-Manero, Guillermo

AU - Ravandi, Farhad

AU - Faderl, Stefan

AU - Borthakur, Gautam

AU - Cortes, Jorge E.

AU - Quintás-Cardama, Alfonso

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N2 - Background: Clofarabine is actively being investigated as a component of frontline chemotherapy for acute myeloid leukemia (AML). Hepatotoxicity is 1 of the primary adverse events associated with clofarabine and can occasionally can include severe venoocclusive disease (VOD). Patients and Methods: Many patients with AML undergo allogeneic stem cell transplantation (allo-SCT), a procedure that is also associated with hepatotoxicity. We identified AML patients undergoing allo-SCT and stratified them according to whether they received clofarabine-containing (clofarabine, idarubicin, and cytarabine [CIA]) or non-clofarabine-containing cytarabine-based induction/consolidation chemotherapy (idarubicin and cytarabine [ara-C] [IA]). We compared both groups for differences in posttransplantation hepatotoxicity, VOD, and other transplantation outcomes. Forty-two patients were identified (20 receiving CIA and 22 receiving IA). Patient and transplant characteristics were similar. All patients receiving clofarabine-based treatment received CIA within 2.5 months of their allo-SCT. Results: There was no difference in the incidence of VOD in the 30 days after transplantation (0 CIA, 1 IA; P = 1.0). Rates of grade 3/4 hepatotoxicity also did not differ between groups. Acute graft-versus-host disease (GVHD), early relapse, and survival were also not significantly different. Conclusions: We conclude that clofarabine-containing chemotherapy does not adversely impact the outcome of allo-SCT. Specifically, it does not predispose patients to an increased risk of hepatotoxicity, VOD, GVHD, or relapse.

AB - Background: Clofarabine is actively being investigated as a component of frontline chemotherapy for acute myeloid leukemia (AML). Hepatotoxicity is 1 of the primary adverse events associated with clofarabine and can occasionally can include severe venoocclusive disease (VOD). Patients and Methods: Many patients with AML undergo allogeneic stem cell transplantation (allo-SCT), a procedure that is also associated with hepatotoxicity. We identified AML patients undergoing allo-SCT and stratified them according to whether they received clofarabine-containing (clofarabine, idarubicin, and cytarabine [CIA]) or non-clofarabine-containing cytarabine-based induction/consolidation chemotherapy (idarubicin and cytarabine [ara-C] [IA]). We compared both groups for differences in posttransplantation hepatotoxicity, VOD, and other transplantation outcomes. Forty-two patients were identified (20 receiving CIA and 22 receiving IA). Patient and transplant characteristics were similar. All patients receiving clofarabine-based treatment received CIA within 2.5 months of their allo-SCT. Results: There was no difference in the incidence of VOD in the 30 days after transplantation (0 CIA, 1 IA; P = 1.0). Rates of grade 3/4 hepatotoxicity also did not differ between groups. Acute graft-versus-host disease (GVHD), early relapse, and survival were also not significantly different. Conclusions: We conclude that clofarabine-containing chemotherapy does not adversely impact the outcome of allo-SCT. Specifically, it does not predispose patients to an increased risk of hepatotoxicity, VOD, GVHD, or relapse.

KW - Acute myeloid leukemia

KW - Allogeneic stem cell transplantation

KW - Clofarabine

KW - Hepatotoxicity

KW - Venoocclusive disease

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