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Clinical Use of Clofarabine for Adults and Children with Leukemia

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Chemotherapy for Leukemia

Abstract

Clofarabine is a second-generation nucleoside analogue designed to be more effective than precursor nucleoside analogues such as fludarabine and cladribine. Early clinical studies of clofarabine demonstrated its activity in hematologic malignancies, and clofarabine was approved by the United States Food and Drug Administration (FDA) for the treatment of relapsed and refractory pediatric acute lymphoblastic leukemia (ALL) in 2004. Clofarabine has significant efficacy in adults and children with hematologic malignancies including ALL, acute myeloid leukemia (AML), and myelodysplastic syndrome (MDS). The unique biochemical modulation properties of clofarabine when used in combination with other established antileukemic drugs also make it an appealing agent for use in combination therapy with purine nucleoside analogues or DNA-damaging agents; these combinations have been tested in a number of studies in patients with ALL or AML. In this chapter, we review the development of clofarabine, the rationale and history of its use in combination regimens, and the potential roles and toxicities of these regimens in the treatment of adult and pediatric leukemias. The use of clofarabine in conditioning regimens prior to stem cell transplantation and for histiocytosis is also discussed.

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Authors and Affiliations

  1. Division of Leukemia, John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, NJ, USA

    James McCloskey, Jamie Koprivnikar & Stefan Faderl

  2. Paediatric Hematology and Oncology, Medical Center, University of Essen, Essen, Germany

    Dirk Reinhardt

  3. Division of Hematology Oncology and Stem Cell Transplant, Ann and Robert H Lurie Children’s Hospital of Chicago, Department of Pediatrics, Northwestern University Feinberg School of Medicine, 225E Chicago Avenue, Box #30, Chicago, IL, 60611, USA

    Nobuko Hijiya

  4. Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Evanston, IL, USA

    Nobuko Hijiya

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  1. James McCloskey
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  2. Jamie Koprivnikar
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  3. Stefan Faderl
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  4. Dirk Reinhardt
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  5. Nobuko Hijiya
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Correspondence to Nobuko Hijiya .

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  1. University of Fukui, Fukui, Japan

    Takanori Ueda

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McCloskey, J., Koprivnikar, J., Faderl, S., Reinhardt, D., Hijiya, N. (2017). Clinical Use of Clofarabine for Adults and Children with Leukemia. In: Ueda, T. (eds) Chemotherapy for Leukemia. Springer, Singapore. https://doi.org/10.1007/978-981-10-3332-2_17

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