A clofarabine-based bridging regimen in patients with relapsed ALL and persistent minimal residual disease (MRD)

作者：Gossai N; Verneris M R; Karras N A; Gorman M F; Patel N J; Burke M J^*

来源：Bone Marrow Transplantation, 2014, 49(3): 440-442.

DOI：10.1038/bmt.2013.195

• ALL
• MRD
• pediatric
• transplantation
• clofarabine
• leukemia

In patients with relapsed ALL, minimal residual disease (MRD) identified prior to allogeneic hematopoietic cell transplantation (HCT) is a strong predictor of relapse. We report our experience using a combination of reduced-dosing clofarabine, CY and etoposide as a %26apos;bridge%26apos; to HCT in eight patients with high risk or relapsed ALL and pre-HCT MRD. All patients had detectable MRD (%26gt; 0.01%, flow cytometry) at the start of therapy with all eight achieving MRD reduction following one cycle. The regimen was well tolerated with seven grade 3/4 toxicities occurring among four of the eight patients. Five patients (62.5%) are alive, one died from relapse (12.5%) and two from transplant-related mortality (25%). The combination of reduced-dose clofarabine, CY and etoposide as bridging therapy appears to be well tolerated in patients with relapsed ALL and is effective in reducing pre-HCT MRD.

• 出版日期2014-3