A Study of the Complete Response Rate with a Combination of High Dose Cytarabine and Cladribine in Refractory and Relapsed Acute Leukemia

  • Reza Safaei Nodehi Tehran University of Medical Sciences- Hematology, Oncology and BMT Department
  • Behrouz Gharib Tehran University of Medical Sciences- Hematology and Oncology resident
  • Ramazaali Sharifian Tehran University of Medical Sciences- Hematology, Oncology and BMT Department
  • Amirhossein Emami Tehran University of Medical Sciences- Hematology, Oncology and BMT Department
  • Majid Moghadaszadeh Tabriz Azad University of Medical Sciences-Tabriz Young Researchers Club
  • Sara Sardashti Tabriz University of Medical Sciences
Keywords: Acute Leukemia, Chemotherapy Regimen, Mortality

Abstract

Introduction: Acute leukemia covers a broad spectrum of hematological clonal diseases originating from the malignant transformation of stem cells. Current chemotherapeutic methods result in an incomplete response to primary regimens in 30-40% of cases.Methods: 20 patients who had been diagnosed with acute leukemia and who had displayed defined criteria in order to enter our study, were assessed in a clinical trial. A combined chemotherapy regimen with Cladribine and Cytarabine was used in the evaluation of the response to treatment and other parameters between the two ALL (acute lymphoblastic leukemia) and AML (acute myeloid leukemia) groups.Results: Average patient age was 32.5±11.3. 13 patients (65%) were male and 7 patients (35%) were female. The average blast count was 67.7% ±18.3% in the AML group while this count was 63.8±19.6% in the ALL group. 5 out of 11 (45.5%) AML patients and 4 out of 9 ALL patients (44.4%) died during our experiment with no significant statistical difference between the two groups (P=0.65). 4 of the AML patients (36.4%) showed complete response while 4 cases (36.4%) were refractory. In the ALL group, there were 3 patients (33.3%) with complete response and 5 (55.6%) were refractory cases.Conclusion: According to the results of the present study compared to other similar studies, a combined chemotherapy regimen of Cladribine and Cytarabine can be used in acute relapsed and refractory leukemia, however, with high toxicity and high early mortality. If factors are controlled, mortality can be reduced in some cases.

References

Atra A, Gerrard M, Hobson R, et al. Outcome of Relapsed or Refractory Childhood B-cell Acute Lymphoblastic Leukemia and B-cell non-Hodgkin’s Lymphoma Treated with the UKCCSG 9003/9002 Protocols. Br J Haematol, 2001; 112: 965-968.

Pastore D, Specchia G, Carluccio P, et al. FLAG-IDA in the Treatment of Refractory/Relapsed Adult Acute Myeloid Leukemia: Single Center Experience. Ann Hematol, 2003; 82: 231-235.

Camera A, Annino L, Chiurazzi F, et al. GIMEMA ALLrescue 97: A Salvage Strategy for Primary Refractory or Relapsed Adult Acute Lymphoblastic Leukemia. Haematologica 2004; 89: 145-153.

Robak T, Wrzesien-Kus A. The Search for Optimal Treatment in Relapsed and Refractory Acute Myeloid Leukemia. Leuk Lymph, 2002; 43: 281-291.

Specchia G, Pastore D, Carluccio P, et al. FLAG-IDA in the Treatment of Refractory/Relapsed Adult Acute Lymphoblastic Leukemia. Ann Hematol, 2005; 84: 792-795.

Wrzesien-Kus A, Robak T, Lech-Maranda E. A Multicenter, Open, non-Comarative, Phase II Study of the Combination of Cladribine (2-Chlorodeoxyadenosine), Cytarabine, and G-CSF as Induction Therapy in Refractory Acute Myeloid Leukemia-areport of the Polish Adult Leukemia Group (PALG). Eur J Hematol, 2003; 71 (3): 155- 162.

How to Cite
1.
Safaei Nodehi R, Gharib B, Sharifian R, Emami A, Moghadaszadeh M, Sardashti S. A Study of the Complete Response Rate with a Combination of High Dose Cytarabine and Cladribine in Refractory and Relapsed Acute Leukemia. ijhoscr. 4(1):5-.
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