Clofarabine, cyclophosphamide, and etoposide (CLOVE) in adult patients with relapsed/refractory acute T-cell lymphoblastic leukemia: single-center experience

Authors : Zeynep Tuğba GÜVEN, Şaziye Esra TUBAY, Serhat ÇELİK, Muzaffer KEKLİK, Ali ÜNAL

Pages : 535-540

Doi:10.17826/cumj.1274325

View : 46 | Download : 143

Publication Date : 2023-07-02

Article Type : Research Paper

Abstract :Purpose: Clofarabine is a second-generation purine analog that inhibits DNA synthesis. It is used as an effective new agent in relapsed refractory acute leukemia. We aimed to report our single center experience about CLOVE protocol as a clofarabine-based regimen in patients with relapsed or refractory T-cell acute lymphoblastic leukemia. Materials and Methods: Thirteen patients with relapsed or resistant T-cell acute lymphoblastic leukemia were included in this study. Patients were administered clofarabine insert ignore into journalissuearticles values(40 mg/m2/day);, etoposide insert ignore into journalissuearticles values(100 mg/m2/day);, and cyclophosphamide insert ignore into journalissuearticles values(440 mg/m2/day); insert ignore into journalissuearticles values(5 days chemotherapy);. The patients\` data were reviewed retrospectively, the demographic and clinical characteristics of patients were recorded. Results: The patients\` median age was 47, and 77% insert ignore into journalissuearticles values(n:10); of them were male. The median number of chemotherapy regimens they received before clofarabine was 3. Of the patients, 54% insert ignore into journalissuearticles values(n=7); presented with relapse, and 46% insert ignore into journalissuearticles values(n=6); with refractory disease. Hematological side effects were observed in all patients during treatment, and 4 insert ignore into journalissuearticles values(31%); patients were complicated by febrile neutropenia. Other side effects were hepatotoxicity 39%, skin reaction 2%, nausea 54%, and mucositis 31%. Three insert ignore into journalissuearticles values(23%); patients were unresponsive to treatment. A response was obtained in 10 insert ignore into journalissuearticles values(77%); patients. Allogeneic stem cell transplantation was performed in 4 of 5 patients with complete response. The median follow-up time after CLOVE was 2.3 insert ignore into journalissuearticles values(0.69-26.02); months. The median estimated survival time was 21.04 ± 3.88 insert ignore into journalissuearticles values(95%CI: 13.43 -28.64); months. Overall survival was 85.7% at three months and 57.1% at one year. Three patients were alive at the end of our study. Conclusion: The combination of clofarabine, etoposide, and cyclophosphamide insert ignore into journalissuearticles values(CLOVE); appears to be successful in achieving a response in relapsing or resistant acute leukemia. However, more effective regimens are still needed.
Keywords : Klofarabin, tekrarlayan dirençli lösemi, T hücreli akut lenfoblastik lösemi