CLAG-M chemotherapy followed by umbilical cord blood stem cell transplantation for primary refractory acute myeloid leukaemia in a child: A case report

Table 1 Cladribine-based chemotherapy in patients with acute myeloid leukaemia

Ref.	Patient number	Patient characteristic	Age	Regimen	Overall response rate, %	Number of patients who received subsequent HSCT	OS	Early death, n
Santana et al[2], 1991	31	Paediatric, R/R ALL and AML	10 (1-21) yr	2- CdA	11% (25% in AML)	NR	NR	3
Santana et al[9], 1992	24	Paediatric, R/R ALL and AML	11 (3-23) yr	2- CdA	CR: 47% (8/17), PR: 12% (2/17)	7	NR	0
Rubnitz et al[10], 2004	8	Paediatric, R/R AML	5.0 (0.6-16.0) yr	2-CdA + Ara-C	0	0	NR	NR
Rubnitz et al[11], 2009	102	Paediatric, ND AML	9.03 (0.05-21.00) yr	2-CdA + Ara-C, followed by DAE	CR 50%	32 (Allo-HSCT)9 (Auto-HSCT)	5-yr OS: 50.0% ± 5.5%	15
Inaba et al[12], 2010	26	Paediatric, R/R AML	10.0 (1.0-19.0) yr	2-CdA + Topotecan	CR 34.6%PR 30.4%	8	Long-term survival: 19.2%	4
Chaleff et al[13], 2012	104	Paediatric, R/R	75 (33–95) mo	2- CdA + IDA	51%	NR	26% at 2 yr	5
Wrzesien-Kus et al[14], 2003	58	Adult, R/R	45 (18–67) yr	CLAG	50%	2 (Allo-HSCT)4 (Auto-HSCT)	42% at 1 yr	10
Wierzbowska et al[3], 2008	118	Adult, R/R	45 (20–66) yr	CLAG-M	58%	20 (Allo-HSCT)6 (Auto-HSCT)	14% at 4 yr	7
Price et al[15], 2010	162	Adult, R/R	CLAG: 55.1 (23.0–83.0) yr, MEC: 55.0 (21.0–90.0) yr	CLAG/MEC	CR: 37.9% (CLAG), CR: 23.8% (MEC)	NR	Median survival: 11.0 mo (CLAG), 4.5 mo (MEC)	9.4% (CLAG), 10.9% (MEC)
Park et al[17], 2016	120	Adult, R/R	56.6 (19.0–83.0) yr	CLAG/CLAG-M/FLAG/FLAGI/mFLAI	CR: 62.7% (CLAG/CLAGM), CR: 61.4% (FLAG/FLAGI/mFLAI)	33	34.0% at 1 yr, 21.4% at 5 yr	NR
Bao et al[18], 2017	103	Adult, R/R	CLAG: 51.0 ± 17.7 yr, FLAG: 48.8 ± 17.5 yrs	CLAG/FLAG	CR: 61.7% (CLAG), CR: 48.7% (FLAG)	11 (CLAG), 10 (FLAG)	CLAG: 45.5% at 1 yr, 35.3% at 3 yr, FLAG: 35.4% at 1 yr, 26.8% at 3 yr	NR
Seligson et al[16], 2018	37	Adult, ND	7 + 3 IA: 61 (27-79) yr, 7 + 3 + 5 IAC: 58 (36-71) yr	7 + 3 IA/ 7 + 3 + 5 IAC	CR: 42% (7 + 3 IA), CR: 34% (7 + 3 + 5 IAC)	NR	NR	NR
Mirza et al[19], 2017	38	Adult, R/R	62 (26-79) yr	CLAG + Imatinib	CR: 37%, PR: 11%	8	11.1 mo (95%CI: 4.8-13.4 mo)	2

2-CdA: Cladribine; ALL: Acute lymphoblastic leukaemia; AML: Acute myeloid leukaemia; Ara-C: Cytarabine; CI: Confidence interval; CLAG: Cladribine, cytarabine and granulocyte colony-stimulating factor; CLAG-M: Cladribine, cytarabine, granulocyte colony-stimulating factor and mitoxantrone; CR: Complete remission; DAE: doxorubicin hydrochloride, bevacizumab, and everolimus; FLAG: Fludarabine, cytarabine and granulocyte colony-stimulating factor; FLAGI: Fludarabine, cytarabine, granulocyte colony-stimulating factor and idarubicin; HSCT: Haematopoietic stem cell transplantation; IA: Idarubicin and cytarabine; IAC: Idarubicin, cytarabine and cladribine; IDA: Idarubicin; MEC: Mitoxantrone, etoposide and cytarabine; mFLAI: Modified fludarabine, cytarabine, and attenuated-dose idarubicin; ND: Newly diagnosed; NR: Not reported; OS: Overall survival; PR: Partial remission; R/R: Refractory and/or relapse.