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Efficacy and toxicity of cladribine for the treatment of refractory acute myeloid leukemia: a meta-analysis

Authors Zhou A, Han Q, Song H, Zi J, Ma J, Ge Z

Received 3 March 2019

Accepted for publication 26 April 2019

Published 29 May 2019 Volume 2019:13 Pages 1867—1878

DOI https://doi.org/10.2147/DDDT.S207425

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Melinda Thomas

Peer reviewer comments 2

Editor who approved publication: Dr Anastasios Lymperopoulos


Anqi Zhou, Qi Han, Huihui Song, Jie Zi, Jinlong Ma, Zheng Ge

Department of Hematology, Zhongda Hospital Southeast University, Institute of Hematology Southeast University, Nanjing 210009, People’s Republic of China

Purpose: To investigate the overall efficacy and toxicity of cladribine and cladribine-based chemotherapy in the treatment of patients with refractory acute myeloid leukemia (AML) based on meta-analysis.
Methods: PubMed, EMBASE database, and the Cochrane Library were searched for relevant studies. Eligible studies were clinical trials of refractory AML assigned to cladribine with data on efficacy including complete remission (CR) rate, overall response rate (ORR) and overall survival. Toxicity was evaluated based on the early death rate and the incidence of grade 3 and 4 adverse events (AEs).
Results: A total of 10 clinical trials including 422 refractory AML patients were analyzed. The overall CR rate was 42.2% (95% CI: 31.0–54.3%). And the ORR of seven trials including 235 patients was 49.7% (95% CI: 33.5–66.0%). The overall early death rate of 260 patients enrolled in five trials was 6.8% (95% CI: 4.3–10.6%). Thrombocytopenia, anemia, neutropenia, and infection were the most common grade 3 and 4 AEs.
Conclusion: Cladribine is effective for refractory AML, and its efficacy can be increased with the combination of cladribine, cytarabine, and granulocyte-colony stimulating factor regimen.

Keywords: cladribine, acute myeloid leukemia, refractory AML, meta-analysis


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