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Posted by on Jul 28, 2019 in Leukemia | 0 comments

In a nutshell

This study aimed to investigate if the combination of cladribine, cytarabine, and granulocyte colony-stimulating factor (G-CSF) could act as salvage treatment for patients with relapsed or unresponsive acute myeloid leukemia.  

This study concluded that this treatment was safe and effective in these patients. 

Some background

Outcomes for patients with unresponsive or early relapsed acute myeloid leukemia (AML) are usually poor and their treatment options are limited.  

Salvage treatment is a treatment used if the cancer does not respond to the initial treatment. Cladribine (Leustatin) and cytarabine (Cytosar-U) are chemotherapies. G-CSF (Filgrastim) allows the growth of cells and can be used after chemotherapy to help healthy blood cells to recover.  

It was unknown if the combination of cladribine, cytarabine, and G-CSF could act as a salvage treatment for patients with relapsed/unresponsive AML. 

Methods & findings

This study involved 36 patients with relapsed/unresponsive AML (AML). 32 of these patients had de novo AML (first cancer) and the other 4 had secondary (occurring after treatment for another cancer) AML. Patients received a combination of cladribine (5mg per day) and intermediate-dose cytarabine (1mg per day) for 5 days. Patients then received G-CSF

Complete remission (no sign of cancer left) was achieved in 58% of patients with tolerable side effects. Side effects included low white blood cell counts, anemia, infections, and bleeding. 

15 of the 36 patients involved later underwent stem cell transplant. These patients had a 73% 1-year overall survival rate. This was compared to a 29% rate for patients that did not have a transplant.  

The bottom line

This study concluded that the combination of salvage treatment of cladribine, cytarabine, and G-CSF was safe and effective in patients with relapsed or unresponsive AML. It was also concluded that this treatment was especially effective in patients who had a subsequent transplant. 

The fine print

This study had a very small number of participants. Further studies are needed.

Published By :

Annals of Hematology

Date :

Jun 14, 2019

Original Title :

Modified cladribine, cytarabine, and G-CSF as a salvage regimen in patients with relapsed/refractory acute myeloid leukemia: a bridge to myeloablative allogeneic hematopoietic stem cell transplantation.

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