Retrospective comparison of clofarabine versus fludarabine in combination with high-dose cytarabine with or without granulocyte colony-stimulating factor as salvage therapies for acute myeloid leukemia
Pamela S. Becker,
Hagop M. Kantarjian,
Frederick R. Appelbaum,
Barry Storer,
Sherry Pierce,
Jianqin Shan,
Stephan Faderl,
Elihu H. Estey
Affiliations
Pamela S. Becker
Divisions of Hematology and Medical Oncology, University of Washington, USA
Hagop M. Kantarjian
Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
Frederick R. Appelbaum
Divisions of Hematology and Medical Oncology, University of Washington, USA;Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle WA, USA
Barry Storer
Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle WA, USA
Sherry Pierce
Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
Jianqin Shan
Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
Stephan Faderl
Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
Elihu H. Estey
Divisions of Hematology and Medical Oncology, University of Washington, USA;Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle WA, USA
We recently reported that clofarabine, high-dose cytarabine, and granulocyte colony-stimulating factor (GCLAC) produced a 46% complete remission rate in relapsed/refractory acute myeloid leukemia. GCLAC differs from FLAG by substitution of clofarabine for fludarabine, raising the question of the relative efficacy of these two regimens. We compared GCLAC given at the University of Washington Medical Center/Fred Hutchinson Cancer Research Center to fludarabine and cytarabine (FA) and FLAG given at MD Anderson Cancer Center. Independent multivariate analyses conducted at both institutions showed that after accounting for duration of first complete remission, salvage number, age, and cytogenetics, GCLAC was associated with a higher complete remission rate (odds ratio 9.57, P
