Cladribine, cytarabine and idarubicin (CLA-Ida) salvage chemotherapy in relapsed acute myeloid leukemia (AML).

Fridle, Chantal; Medinger, Michael; Wilk, Matthias C; Seipel, Katja; Passweg, Jakob; Manz, Markus G; Pabst, Thomas (2017). Cladribine, cytarabine and idarubicin (CLA-Ida) salvage chemotherapy in relapsed acute myeloid leukemia (AML). Leukemia & lymphoma, 58(5), pp. 1068-1075. Informa Healthcare 10.1080/10428194.2016.1235274

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BACKGROUND

The prognosis for relapsing AML patients is disappointing and the preferred salvage chemotherapy is unclear. Among other regimens, cladribine, cytarabine, and idarubicin (CLA-Ida) is used.

METHODS

We analyzed relapsing AML patients receiving CLA-Ida chemotherapy between July 2012 and April 2015 at three academic centers in Switzerland.

RESULTS

Thirty-four patients underwent at least one cycle of CLA-Ida chemotherapy, with 6 patients having two cycles. Treatment-related mortality was 5.9% (2/34 patients). Eighteen patients (52.9%) achieved a complete remission (CR2), and 16 (47.1%) received subsequent allogeneic transplantation, with 8 (23.5%) of these patients remaining in complete remission after a median follow-up of 6 months. In contrast, all 16 patients not achieving CR2 died within 12 months after relapse due to progressive disease.

CONCLUSION

Our data suggest a promising rate of complete remission following CLA-Ida salvage treatment in relapsing AML patients enabling a substantial proportion of such patients to proceed to allogeneic transplantation.

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