Successful combination chemotherapy involving clofarabine, cyclophosphamide, and etoposide for pediatric relapsed acute myeloid leukemia: A case report

Abstract

Limited salvage chemotherapies are available for relapsed/refractory acute myeloid leukemia. Herein, we described successful reinduction chemotherapy, involving a combination of clofarabine, cyclophosphamide, and etoposide, in a 12-year-old male with relapsed acute myeloid leukemia prior to allogeneic bone marrow transplantation from his father. Although treatment with a combination of fludarabine, cytarabine, granulocyte colony-stimulating factor, idarubicin, and gemtuzumab ozogamicin had no positive effects, the aforementioned clofarabine-based chemotherapy induced complete remission and allowed the transplantation to go ahead. The abovementioned regimen may be useful for induction chemotherapy prior to hematopoietic stem cell transplantation for refractory/relapsed acute myeloid leukemia.

Gemtuzumab Ozogamicin Monotherapy Is a Well-tolerated Palliative Chemotherapy Option in Pediatric Multiply Relapsed Acute Myeloid Leukemia: A Multicenter Case Series and Review of the Literature

“…Integrating strategies to personalize the use of GO in upfront AML trials could avoid unnecessary exposure of patients to this drug. 4,[42][43][44] It remains unknown if prior exposure to GO is a negative predictive outcome in GO monotherapy in R/ R AML.…”

“…In fact, OS of children with relapsed AML remains poor at 40%. 4,5 When curative intent treatments are no longer possible, palliative chemotherapy is often considered to prolong life, while optimizing patients' quality of life and respect for their wishes. In this review, we report 4 cases of multiply relapsed pediatric AML patients who were treated with gemtuzumab ozogamicin (GO) monotherapy with palliative intent.…”

“…New optimized therapeutic avenues for refractory/relapsed disease are yet to be discovered. In fact, OS of children with relapsed AML remains poor at 40% 4,5 . When curative intent treatments are no longer possible, palliative chemotherapy is often considered to prolong life, while optimizing patients’ quality of life and respect for their wishes.…”