Cladribine combined with high doses of arabinoside cytosine, mitoxantrone, and G‐CSF (CLAG‐M) is a highly effective salvage regimen in patients with refractory and relapsed acute myeloid leukemia of the poor risk: a final report of the Polish Adult Leukemia Group

Abstract

We conclude that CLAG-M is a well-tolerated and highly effective salvage regimen in poor risk refractory/relapsed AML.

Assessing the efficacy of allogeneic hematopoietic stem cells transplantation (allo‐HSCT) by analyzing survival end points in defined groups of acute myeloid leukemia patients: A retrospective, multicenter Polish Adult Leukemia Group study

“…As alternative reinduction chemotherapy, CLAG [14,15] and CLAG-M [16] were respectively used in Studies 1 and 2. In the former, patients with intermediate or high cytogenetic risk and those patients requiring two induction treatments to achieve CR were qualified for allo-HSCT.…”

Treated secondary acute myeloid leukemia: a distinct high-risk subset of AML with adverse prognosis

“…41,42 Combinatorial regimens built around a high-dose cytarabine backbone such as fludarabine, Ara-C, idarubicin, and granulocyte colonystimulating factor and cladribine-Ara-C, purportedly improve upon the cytotoxic effects of HiDAC, and are fairly equivalent in efficacy. [43][44][45] However, there is mounting evidence to suggest that responses, even to escalated doses of Ara-C, are heavily dependent upon the underlying cytogenetic and molecular signatures. 46 There is an urgent need for genetic annotation to define patients who best benefit from cytarabine-based therapy.…”

Comparable outcomes between autologous and allogeneic transplant for adult acute myeloid leukemia in first CR

“…The regimens represent purine analog (eg, fludarabine, cladribine, clofarabine)-containing regimens, which have shown remission rates of 30% to 45% in several clinical trials, and those that have been used as the comparator arms in U.S. cooperative group trials in the past decade. The representative regimens included are: 1) cladribine, cytarabine, and granulocyte colony-stimulating factor (G-CSF), with or without mitoxantrone or idarubicin 218,219 ; 2) fludarabine, cytarabine, and G-CSF (FLAG regimen) with or without idarubicin 220,221 ; 3) etoposide and cytarabine, with or without mitoxantrone 222 ; 4) clofarabine (25 mg/m 2 daily for 5 days), cytarabine (2 g/m 2 daily for 5 days), and G-CSF 223 ; or 5) clofarabine-and idarubicin-containing regimens with clofarabine (22.5 mg/m 2 daily for 5 days) and idarubicin (10 mg/m 2 daily for 3 days) or clofarabine (same as above) and idarubicin (6 mg/m 2 daily for 3 days) and cytarabine (0.75 g/m 2 daily for 5 days). 224 More recently, a regimen with clofarabine (40 mg/m 2 ) combined with cytarabine (2 g/m 2 ) was evaluated in a randomized, placebo-controlled, phase III trial (CLASSIC I trial) in relapsed/refractory AML, resulting in an ORR of 47% (CR rate 35%) and median OS of 6.6 months.…”