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

4 Scopus citations

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

Keywords

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

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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