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Medline ® Abstract for Reference 38

of 'Treatment of relapsed or refractory acute lymphoblastic leukemia in adults'

The use of higher dose clofarabine in adults with relapsed acute lymphoblastic leukemia.
McGregor BA, Brown AW, Osswald MB, Savona MR
Am J Hematol. 2009;84(4):228.
The standard dose of clofarabine is 52 mg/m2 for pediatrics and 40 mg/m2 in adults. Clofarabine dosed at 52 mg/m2 was used in adult patients with refractory ALL to maximize response before allo-HSCT. All patients had a significant response to therapy. Published pharmacokinetic analysis revealed no difference in peak plasma or intracellular concentrations at clofarabine dosed above 40 mg/m2, yet inhibition of replication in leukemia cells was only sustained over 24 hr at 55 mg/m2. Despite this, there have been no reports of high dose clofarabine used in this setting. Our experience implies that there may be a niche role for clofarabine in reducing disease burden before allo-HSCT for adults with relapsed ALL.
Department of Medicine, Hematology-Oncology, San Antonio Military Medical Center, San Antonio, Texas, USA.