Clofarabine in the Treatment of Elderly Patients with AcuteMyeloid Leukemia

Background: Elderly patients with acute myeloid leukemia (AML) have a poor outcome because of comorbidities,poor tolerance to intensive chemotherapy and inherently more resistant disease. Clofarabine is asecond generation nucleoside analogue which has shown promising activity in elderly patients with AML. Thisstudy was conducted to review the outcome of treatment with clofarabine in a group of such patients.
Methods:The records of 5 elderly patients who were diagnosed to have AML and treated with clofarabine over a 12month period were reviewed retrospectively.
Results: There were 2 female and 3 male patients with a medianage of 68 years (range 65-82). At the time of treatment, 2 patients had newly diagnosed AML not consideredsuitable for intensive therapy, while 3 patients had partial or no response to conventional chemotherapy. Theoverall response rate was 100%, all patients achieving a complete remission. Induction and consolidation werewell tolerated. All patients developed neutropenia with a median duration of 20 days (range 17-42). One patientdeveloped hand and foot syndrome and a generalized rash but recovered. There was no mortality and all patientsremained in remission after a median follow-up of 5.2 months (Range 3-10).
Conclusion: Clofarabine (alone orin combination) is active in elderly AML patients with an acceptable safety profile and should be considered apotential option in this group.