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Medline ® Abstract for Reference 27

of '复发或难治性急性髓系白血病的治疗'

Cladribine in the treatment of acute myeloid leukemia: a single-institution experience.
Martin MG, Welch JS, Augustin K, Hladnik L, DiPersio JF, Abboud CN
Clin Lymphoma Myeloma. 2009;9(4):298.
BACKGROUND: Despite advances in novel therapeutics, supportive care, and postremission therapy, the outcome of high-risk and elderly patients as well as those with relapsed/refractory acute myeloid leukemia (AML) remains poor. There is likely still room for improvement through optimizing conventional chemotherapy.
PATIENTS AND METHODS: Through a pharmacy database search we identified all patients with AML treated at Washington University with cladribine-based regimens.
RESULTS: Twenty-four patients were identified that were treated with 2 cladribine-based regimens: CLAG (cladribine [5 mg/m2 days 1-5], cytarabine [2 g/m2 days 1-5]and granulocyte colony-stimulating factor [G-CSF; 300 microg subcutaneously (s.c.) days 0-5]) and CLAM (cladribine [5 mg/m2 days 1-5], cytarabine [2 g/m2 days 1-5], G-CSF [300 mg s.c. days 0-5]and mitoxantrone [10 mg/m2 days 1-3]). Complete responses were achieved in 53% of patients given induction chemotherapy and 44% of those given salvage chemotherapy. The regimens were well tolerated with minimal extramedullary toxicity.
CONCLUSION: These data suggest that cladrabine-based regimens should be further explored in both the salvage and first-line setting and might offer an attractive backbone on which to add novel therapies.
Section of Leukemia and Bone Marrow Transplantation, Division of Oncology, Washington University School of Medicine, Saint Louis, MO 63110, USA. mmartin@dom.wustl.edu