回顾性比较克拉屈滨与氟达拉滨联合高剂量阿糖胞苷联合或不联合粒细胞集落刺激因子作为急性髓细胞白血病的挽救疗法。
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.
机构信息
Divisions of Hematology and Medical Oncology, University of Washington, USA.
出版信息
Haematologica. 2013 Jan;98(1):114-8. doi: 10.3324/haematol.2012.063438. Epub 2012 Jul 16.
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<0.0001) and longer survival (mortality hazard ratio 0.43, P=0.0002). Despite the retrospective nature of the analyses, GCLAC may be superior to FA/FLAG, particularly in patients with short duration of first complete remission or unfavorable cytogenetics.
我们最近报道,在复发/难治性急性髓系白血病患者中,氯法拉滨、高剂量阿糖胞苷和粒细胞集落刺激因子(GCLAC)的完全缓解率为 46%。GCLAC 通过用氯法拉滨替代氟达拉滨与 FLAG 不同,这引发了这两种方案相对疗效的问题。我们比较了华盛顿大学医学中心/弗雷德哈钦森癌症研究中心使用的 GCLAC 与 MD 安德森癌症中心使用的氟达拉滨和阿糖胞苷(FA)和 FLAG。在这两个机构进行的独立多变量分析表明,在考虑到首次完全缓解的持续时间、挽救治疗次数、年龄和细胞遗传学后,GCLAC 与更高的完全缓解率(优势比 9.57,P<0.0001)和更长的生存时间(死亡率风险比 0.43,P=0.0002)相关。尽管分析具有回顾性,但 GCLAC 可能优于 FA/FLAG,尤其是在首次完全缓解持续时间较短或细胞遗传学不良的患者中。