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Bob Löwenberg, Thomas Pabst, Johan Maertens, Yvette van Norden, Bart J Biemond, Harry C Schouten, Olivier Spertini, Edo Vellenga, Carlos Graux, Violaine Havelange, Georgine E de Greef, Okke de Weerdt, Marie-Cecile J C Legdeur, Juergen Kuball, Marinus van Marwijk Kooy, Bjorn T Gjertsen, Mojca Jongen-Lavrencic, Arjan A van de Loosdrecht, Daniëlle van Lammeren-Venema, Beata Hodossy, Dimitri A Breems, Yves Chalandon, Jakob Passweg, Peter J M Valk, Markus G Manz, Gert J Ossenkoppele
Clofarabine has demonstrated antileukemic activity in acute myeloid leukemia (AML) but has yet to be critically evaluated in younger adults in the frontline with standard chemotherapy. We compared two induction regimens in newly diagnosed patients aged 18-65 with AML/high risk MDS, i.e., idarubicine-cytarabine (cycle I) and amsacrine-cytarabine (cycle II) without or with clofarabine (10 mg/m(2) on days 1-5 of each of both cycles). Consolidation involved chemotherapy with or without hematopoietic stem cell transplantation...
January 3, 2017: Blood
Mohammad Rehan Ajmal, Saima Nusrat, Parvez Alam, Nida Zaidi, Mohsin Vahid Khan, Masihuz Zaman, Yasser E Shahein, Mohamed H Mahmoud, Gamal Badr, Rizwan Hasan Khan
The binding interaction between clofarabine, an important anticancer drug and two important carrier proteins found abundantly in human plasma, Human Serum Albumin (HSA) and α-1 acid glycoprotein (AAG) was investigated by spectroscopic and molecular modeling methods. The results obtained from fluorescence quenching experiments demonstrated that the fluorescence intensity of HSA and AAG is quenched by clofarabine and the static mode of fluorescence quenching is operative. UV-vis spectroscopy deciphered the formation of ground state complex between anticancer drug and the two studied proteins...
December 5, 2016: Journal of Pharmaceutical and Biomedical Analysis
Partow Kebriaei, Roland Bassett, Genevieve Lyons, Ben Valdez, Celina Ledesma, Gabriela Rondon, Betul Oran, Stefan Ciurea, Amin Alousi, Uday Popat, Krina Patel, Sairah Ahmed, Amanda Olson, Qaiser Bashir, Nina Shah, Roy Jones, David Marin, Katayoun Rezvani, Yago Nieto, Issa Khouri, Muzaffar Qazilbash, Chitra Hosing, Elizabeth Shpall, Richard E Champlin, Borje S Andersson
We investigated the long-term safety and disease control data obtained with i.v. busulfan (Bu) combined with clofarabine (Clo) in patients with acute lymphoblastic leukemia (ALL) undergoing allogeneic hematopoietic stem cell transplantation (HSCT). A total of 107 patients, median age 38 years (range, 19 to 64 years) received a matched sibling donor (n = 52) or matched unrelated donor (n = 55) transplant for ALL in first complete remission (n = 62), second complete remission (n = 28), or more advanced disease (n = 17)...
February 2017: Biology of Blood and Marrow Transplantation
Martin Barrio, Claudio Spick, Caius G Radu, Michael Lassmann, Uta Eberlein, Martin S Allen-Auerbach, Christiaan Schiepers, Roger Slavik, Johannes Czernin, Ken Herrmann
BACKGROUND: (18)F-Clofarabine ((18)F-CFA), a nucleotide purine analogue, is a substrate for deoxycytidine kinase (dCK), a key enzyme in the deoxyribonucleoside salvage pathway. (18)F-CFA could be used to measure dCK expression and thus serve as a predictive biomarker for tumor responses to dCK dependent prodrugs or small molecule dCK inhibitors, respectively. As a prerequisite for clinical translation, we determined human whole body and organ dosimetry of (18)F-CFA. METHODS: Five healthy volunteers were injected intravenously with 232...
November 3, 2016: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
Dominik Selleslag, Stefan Suciu, Giovanna Meloni, Petra Muus, Constantijn J M Halkes, Adriano Venditti, Safaa M Ramadan, Hans Pruijt, Liv Meert, Marco Vignetti, Jean-Pierre Marie, Sébastian Wittnebel, Theo de Witte, Sergio Amadori, Roelof Willemze, Frédéric Baron
No abstract text is available yet for this article.
October 27, 2016: Haematologica
Patrice Chevallier, Myriam Labopin, Regis Peffault de La Tour, Bruno Lioure, Claude-Eric Bulabois, Anne Huynh, Didier Blaise, Pascal Turlure, Etienne Daguindau, Natacha Maillard, Ibrahim Yakoub-Agha, Gaelle Guillerm, Jeremy Delage, Nathalie Contentin, Jacques-Olivier Bay, Florence Beckerich, Jean-Henri Bourhis, Marie Detrait, Stéphane Vigouroux, Sylvie François, Faezeh Legrand, Thierry Guillaume, Mohamad Mohty
We have retrospectively compared survivals between acute myeloid leukemia (AML)/myelodysplastic syndrome (MDS) patients who received either a clofarabine/busulfan (CloB2A2) or a fludarabine/busulfan (FB2A2) RIC regimen for allogeneic stem cell transplantation. Between 2009 and 2014, 355 allotransplanted cases were identified from the SFGM-TC registry as having received either the FB2A2 (n = 316, 56% males, median age: 59.2 years, AML 78.5%, first complete remission [CR1] 72%, median follow-up: 20 months) or the CloB2A2 (n = 39, 62% males, median age: 60...
November 2016: Cancer Medicine
Elias Jabbour, Stefan Faderl, Koji Sasaki, Tapan Kadia, Naval Daver, Naveen Pemmaraju, Keyur Patel, Joseph D Khoury, Carlos Bueso-Ramos, Zachary Bohannan, Farhad Ravandi, Gautam Borthakur, Srdan Verstovsek, Darla Miller, Rita Maduike, Chitra Hosing, Hagop M Kantarjian, Guillermo Garcia-Manero
BACKGROUND: The outcome of patients with higher risk myelodysplastic syndromes (MDS) after hypomethylating agent (HMA) failure is poor. This study evaluated the safety and activity of a combination of low-dose clofarabine and cytarabine for these patients. METHODS: Seventy patients with higher risk MDS who had no response, progressed, or relapsed after at least 4 cycles of HMA therapy were treated. RESULTS: The median age was 72 years. Thirty-nine percent of the patients had high-risk disease according to the International Prognostic Scoring System, and 50% of the patients had poor-risk cytogenetics...
October 14, 2016: Cancer
A K Burnett, N H Russell, R K Hills, J Kell, O J Nielsen, M Dennis, P Cahalin, C Pocock, S Ali, S Burns, S Freeman, D Milligan, R E Clark
The study was designed to compare clofarabine plus daunorubicin versus daunorubicin/ara-C in older patients with acute myeloid leukaemia (AML) or high-risk myelodysplastic syndrome (MDS). Eight hundred and six untreated patients in the UK NCRI AML16 trial with AML/high-risk MDS (median age, 67yrs; range 56-84) and normal serum creatinine were randomised to two courses of induction chemotherapy with either daunorubicin/ara-C (DA) or daunorubicin/clofarabine (DClo). Patients were also included in additional randomisations; +/- one dose of gemtuzumab ozogamicin in course 1; 2v3 courses and +/- azacitidine maintenance...
September 2, 2016: Leukemia: Official Journal of the Leukemia Society of America, Leukemia Research Fund, U.K
Kristin V Ho, Dominic A Solimando, J Aubrey Waddell
The complexity of cancer chemotherapy requires pharmacists be familiar with the complicated regimens and highly toxic agents used. This column reviews various issues related to preparation, dispensing, and administration of antineoplastic therapy, and the agents, both commercially available and investigational, used to treat malignant diseases. Questions or suggestions for topics should be addressed to Dominic A. Solimando, Jr, President, Oncology Pharmacy Services, Inc., 4201 Wilson Blvd #110-545, Arlington, VA 22203, e-mail: OncRxSvc@comcast...
November 2015: Hospital Pharmacy
Mohamad Mohty, Florent Malard, Didier Blaise, Noel Milpied, Gérard Socié, Anne Huynh, Oumédaly Reman, Ibrahim Yakoub-Agha, Sabine Furst, Thierry Guillaume, Resa Tabrizi, Stéphane Vigouroux, Pierre Peterlin, Jean El-Cheikh, Philippe Moreau, Myriam Labopin, Patrice Chevallier
The prognosis of patients with acute myeloid leukemia in whom primary treatment fails remains very poor. In order to improve such patients' outcome, we conducted a phase 2, prospective, multicenter trial to test the feasibility of a new sequential regimen, combining a short course of intensive chemotherapy and a reduced intensity-conditioning regimen, before allogeneic stem-cell transplantation. Twenty-four patients (median age, 47 years) with acute myeloid leukemia in primary treatment failure were included...
January 2017: Haematologica
Andrea Ghelli Luserna Di Rorà, Ilaria Iacobucci, Enrica Imbrogno, Cristina Papayannidis, Enrico Derenzini, Anna Ferrari, Viviana Guadagnuolo, Valentina Robustelli, Sarah Parisi, Chiara Sartor, Maria Chiara Abbenante, Stefania Paolini, Giovanni Martinelli
During the last few years many Checkpoint kinase 1/2 (Chk1/Chk2) inhibitors have been developed for the treatment of different type of cancers. In this study we evaluated the efficacy of the Chk 1/2 inhibitor prexasertib mesylate monohydrate in B-/T- cell progenitor acute lymphoblastic leukemia (ALL) as single agent and in combination with other drugs. The prexasertib reduced the cell viability in a dose and time dependent manner in all the treated cell lines. The cytotoxic activity was confirmed by the increment of apoptotic cells (Annexin V/Propidium Iodide staining), by the increase of γH2A...
August 16, 2016: Oncotarget
J Magenau, P Westervelt, S Khaled, J McGuirk, P Hari, M Eapen, P S Becker, B Parkin, T Braun, B Logan, H Wang, M Jagasia, S D Rowley, D D H Kim, T Schechter, N Frey, B Scott, T Churay, S Lieland, S Forman, S Mineishi
Allogeneic hematopoietic cell transplantation (HCT) may produce long-term survival in AML after relapse or primary induction failure (PIF). However, outcomes of HCT performed for AML not in remission are historically poor given high relapse rates and transplant-related mortality. Preliminary studies suggest conditioning with clofarabine and myeloablative busulfan (CloBu4) may exert significant anti-leukemic effects without excessive toxicity in refractory hematologic malignancies. A prospective multicenter phase II trial was conducted to determine the efficacy of CloBu4 for patients proceeding directly to HCT with AML not in remission...
January 2017: Bone Marrow Transplantation
Gheath Alatrash, Peter F Thall, Benigno C Valdez, Patricia S Fox, Jing Ning, Haven R Garber, Selma Janbey, Laura L Worth, Uday Popat, Chitra Hosing, Amin M Alousi, Partow Kebriaei, Elizabeth J Shpall, Roy B Jones, Marcos de Lima, Gabriela Rondon, Julianne Chen, Richard E Champlin, Borje S Andersson
Pretransplant conditioning regimens critically determine outcomes in the setting of allogeneic stem cell transplantation (allo-SCT). The use of nucleoside analogs such as fludarabine (Flu) in combination with i.v. busulfan (Bu) has been shown to be highly effective as a pretransplant conditioning regimen in acute myeloid leukemia (AML), chronic myeloid leukemia (CML), and myelodysplastic syndrome (MDS). Because leukemia relapse remains the leading cause of death after allo-SCT, we studied whether clofarabine (Clo), a nucleoside analog with potent antileukemia activity, can be used to complement Flu...
October 2016: Biology of Blood and Marrow Transplantation
Colleen Delaney, Filippo Milano, Laura Cicconi, Megan Othus, Pamela S Becker, Vicky Sandhu, Ian Nicoud, Ann Dahlberg, Irwin D Bernstein, Frederick R Appelbaum, Elihu H Estey
BACKGROUND: The intensive chemotherapy regimens used to treat acute myeloid leukaemia routinely result in serious infections, largely due to prolonged neutropenia. We investigated the use of non-HLA-matched ex-vivo expanded cord blood progenitor cells to accelerate haemopoietic recovery and reduce infections after chemotherapy. METHODS: We enrolled patients with a diagnosis of acute myeloid leukaemia by WHO criteria and aged 18-70 years inclusive at our institution (Fred Hutchinson Cancer Research Center) into this phase 1 trial...
July 2016: Lancet Haematology
Jia-Jie Luan, Yu-Shan Zhang, Xiao-Yun Liu, Ya-Qin Wang, Jian Zuo, Jian-Guo Song, Wen Zhang, Wu-San Wang
To evaluate the time- and dose-dependent toxicity of clofarabine in mice and to further define the chronotherapy strategy of it in leukemia, we compared the mortality rates, LD50s, biochemical parameters, histological changes and organ indexes of mice treated with clofarabine at various doses and time points. Plasma clofarabine levels and pharmacokinetic parameters were monitored continuously for up to 8 hours after the single intravenous administration of 20 mg/kg at 12:00 noon and 12:00 midnight by high performance liquid chromatography (HPLC)-UV method...
May 2016: Kaohsiung Journal of Medical Sciences
Benigno C Valdez, Jonathan E Brammer, Yang Li, David Murray, Esmeralda C Teo, Yan Liu, Chitra Hosing, Yago Nieto, Richard E Champlin, Borje S Andersson
Novel approaches to pre-transplant conditioning are needed to improve treatment of advanced T-cell malignancies. We investigated the synergism of fludarabine (Flu), clofarabine (Clo), busulfan (Bu), and romidepsin (Rom) in T-cell lines and patient-derived cell samples. [Flu+Clo+Bu+Rom] had combination indexes of 0.4-0.5 at ∼50% cytotoxicity in PEER and SUPT1 cells, suggesting synergism. Drug exposure resulted in histone modifications, DNA-damage response (DDR), increased reactive oxygen species (ROS), decreased glutathione (GSH) and mitochondrial membrane (MM) potential, and apoptosis...
August 2016: Leukemia Research
Christan M Thomas, Cindy Ippoliti, Gail J Roboz, Eric Feldman, Dimitrios Savva, Sara James, Koen van Besien
No abstract text is available yet for this article.
May 31, 2016: Leukemia & Lymphoma
Audrey Grain, Anne Sirvent, Marion Strullu, Mechinaud Françoise, Mohamad Mohty, Thierry Guillaume, Patrice Chevallier, Fanny Rialland
No abstract text is available yet for this article.
May 17, 2016: Leukemia & Lymphoma
Barbara Spitzer, Miguel-Angel Perales, Nancy A Kernan, Susan E Prockop, Emily C Zabor, Nicholas Webb, Hugo Castro-Malaspina, Esperanza B Papadopoulos, James W Young, Andromachi Scaradavou, Rachel Kobos, Sergio A Giralt, Richard J O'Reilly, Farid Boulad
Relapse after allogeneic hematopoietic stem cell transplantation (alloHSCT) remains one of the leading causes of mortality in patients with leukemia. Treatment options in this population remain limited, with concern for both increased toxicity and further relapse. We treated 18 patients with acute leukemia for marrow ± extramedullary relapse after a previous alloHSCT with a myeloablative cytoreductive regimen including clofarabine, melphalan, and thiotepa followed by a second or third transplantation from the same or a different donor...
August 2016: Biology of Blood and Marrow Transplantation
Amir T Fathi, Daniel J DeAngelo, Kristen E Stevenson, Jonathan E Kolitz, Julie D Asch, Philip C Amrein, Eyal C Attar, David P Steensma, Martha Wadleigh, Julia Foster, Christine Connolly, Ilene Galinsky, Craig E Devoe, Richard M Stone, Donna S Neuberg, Karen K Ballen
BACKGROUND: Outcomes among older patients with acute lymphoblastic leukemia remain poor. This study sought to determine the efficacy of an intensified, multi-agent approach derived from a Dana-Farber consortium trial in younger adults for patients older than 50 years (trial identifier NCT00973752). METHODS: The primary endpoint was overall survival (OS) at 1 year. Patients received induction chemotherapy with vincristine, prednisone, doxorubicin, and pegylated asparaginase...
August 1, 2016: Cancer
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