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

N. Gossai, M. R. Verneris, N. A. Karras, M. F. Gorman, N. J. Patel, M. J. Burke

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

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 'bridge' to HCT in eight patients with high risk or relapsed ALL and pre-HCT MRD. All patients had detectable MRD (>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.

Original languageEnglish (US)
Pages (from-to)440-442
Number of pages3
JournalBone marrow transplantation
Volume49
Issue number3
DOIs
StatePublished - Mar 2014

Bibliographical note

Funding Information:
Children’s Cancer Research Fund (MJB, MRV) and the University of Minnesota Pediatric Leukemia Program supported this work.

Keywords

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

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