Abstract | PURPOSE: EXPERIMENTAL DESIGN: Previously treated patients with relapsed/refractory CLL were eligible for this study. Clofarabine was infused over 1 hour daily for 5 days. Most patients received 3 or 4 mg/m2/d x 5 days, whereas the other two were treated with 15 mg/m2/d x 5 days. Clinical outcome and associated pharmacologic end points were assessed. RESULTS: Myelosuppression limited the maximum tolerated dose of clofarabine to 3 mg/m2/d on this schedule. Cellular pharmacokinetic studies showed a median clofarabine triphosphate concentration in CLL lymphocytes of 1.5 micromol/L (range, 0.2-2.3 micromol/L; n = 9). In the majority of cases, >50% of the analogue triphosphate was present 24 hours after infusion, indicating prolonged retention of the triphosphate in CLL cells. Although cytoreduction was observed, no patients achieved a response. In vitro clofarabine incubation of leukemic lymphocytes from 29 CLL patients showed that clofarabine monophosphate accumulated to a higher concentration compared with the triphosphate. Nonetheless, the triphosphate increased in a dose-dependent fashion and upon successive clofarabine infusions, suggesting benefit from greater doses given at less frequent intervals. CONCLUSION:
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Authors | Varsha Gandhi, William Plunkett, Peter L Bonate, Min Du, Billie Nowak, Susan Lerner, Michael J Keating |
Journal | Clinical cancer research : an official journal of the American Association for Cancer Research
(Clin Cancer Res)
Vol. 12
Issue 13
Pg. 4011-7
(Jul 01 2006)
ISSN: 1078-0432 [Print] United States |
PMID | 16818700
(Publication Type: Clinical Trial, Phase I, Journal Article, Research Support, N.I.H., Extramural, Research Support, U.S. Gov't, P.H.S.)
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Chemical References |
- Adenine Nucleotides
- Arabinonucleosides
- Clofarabine
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Topics |
- Adenine Nucleotides
(administration & dosage, adverse effects, pharmacokinetics)
- Aged
- Arabinonucleosides
(administration & dosage, adverse effects, pharmacokinetics)
- Clofarabine
- Dose-Response Relationship, Drug
- Drug Administration Schedule
- Female
- Humans
- Infusions, Intravenous
- Leukemia, Lymphocytic, Chronic, B-Cell
(drug therapy)
- Lymphocytes
(drug effects)
- Male
- Maximum Tolerated Dose
- Middle Aged
- Molecular Structure
- Neoplasm Staging
- Recurrence
- Tissue Distribution
- Treatment Outcome
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