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Cladribine in the remission induction of adult acute myeloid leukemia: where do we stand?

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Abstract

The combination of cytarabine and an anthracycline has been the standard of care for the induction of remission in acute myeloid leukemia (AML). The response to treatment and survival of adult patients with AML are still variable and depend on multiple factors. Therefore, there have been many efforts to improve the response to treatment and survival rates by either increasing the cytarabine dose or adding a third agent to the standard induction chemotherapy regimen. Unfortunately, attempts to improve response and survival have been mostly unsuccessful. Recent clinical trials and retrospective studies explored the addition of cladribine to standard induction chemotherapy for AML. Some of these studies showed higher rates of complete remission, and one showed improved survival. In this review, we will discuss the antileukemic properties of cladribine and summarize the recent clinical data regarding its incorporation into the induction therapy for adult AML.

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  1. Division of Hematology and Blood & Marrow Transplant, Markey Cancer Center, College of Medicine, University of Kentucky, 800 Rose St, Lexington, KY, 40536, USA

    Ayman Qasrawi

  2. Department of Internal Medicine, School of Medicine, University of Missouri-Kansas City, 2411 Holmes St, Kansas City, MO, 64108, USA

    Waled Bahaj, Omar Abughanimeh & John Foxworth

  3. Walmart Pharmacy, 5150 Roe Blvd, Roeland Park, KS, 66205, USA

    Lien Qasrawi

  4. NCI Community Oncology Research Program - Kansas City (NCORP-KC), 4121 W 83rd St #259, Prairie Village, Kansas, USA

    Rakesh Gaur

  5. KIM Cancer and Blood Center, 11227 Lakeview Ave, Lenexa, KS, 66219, USA

    Rakesh Gaur

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Qasrawi, A., Bahaj, W., Qasrawi, L. et al. Cladribine in the remission induction of adult acute myeloid leukemia: where do we stand?. Ann Hematol 98, 561–579 (2019). https://doi.org/10.1007/s00277-018-3562-8

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