{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T15:21:53Z","timestamp":1787239313272,"version":"build-2736575974"},"reference-count":44,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,11,8]],"date-time":"2019-11-08T00:00:00Z","timestamp":1573171200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["P01 CA078902"],"award-info":[{"award-number":["P01 CA078902"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["P30 CA015704"],"award-info":[{"award-number":["P30 CA015704"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Clofarabine is an immunosuppressive purine nucleoside analog that may have better anti\u2010leukemic activity than fludarabine. We performed a prospective phase I\/II multisite trial of clofarabine with 2 Gy total body irradiation as non\u2010myeloablative conditioning for allogeneic hematopoietic cell transplantation in adults with acute myeloid leukemia who were unfit for more intense regimens. Our main objective was to improve the 6\u2010month relapse rate following non\u2010myeloablative conditioning, while maintaining historic rates of non\u2010relapse mortality (NRM) and engraftment. Forty\u2010four patients, 53 to 74 (median: 69) years, were treated with clofarabine at 150 to 250\u2009mg\/m\n                    <jats:sup>2<\/jats:sup>\n                    , of whom 36 were treated at the maximum protocol\u2010specified dose. One patient developed multifactorial acute kidney injury and another developed multiorgan failure, but no other grade 3 to 5 non\u2010hematologic toxicities were observed. All patients fully engrafted. The 6\u2010month relapse rate was 16% (95% CI, 5%\u201027%) among all patients and 14% (95% CI, 3%\u201026%) among high\u2010risk patients treated at the maximum dose, meeting the pre\u2010specified primary efficacy endpoint. Overall survival was 55% (95% CI, 40%\u201070%) and leukemia\u2010free survival was 52% (95% CI, 37%\u201067%) at 2\u2009years. Compared to a historical high\u2010risk cohort treated with the combination of fludarabine at 90\u2009mg\/m\n                    <jats:sup>2<\/jats:sup>\n                    and 2 Gy TBI, protocol patients treated with the clofarabine\u2010TBI regimen had lower rates of overall mortality (HR of 0.50, 95% CI, 0.28\u20100.91), disease progression or death (HR 0.48, 95% CI, 0.27\u20100.85), and morphologic relapse (HR 0.30, 95% CI, 0.13\u20100.69), and comparable NRM (HR 0.85, 95% CI 0.36\u20102.00). The combination of clofarabine with TBI warrants further investigation in patients with high\u2010risk AML.\n                  <\/jats:p>","DOI":"10.1002\/ajh.25665","type":"journal-article","created":{"date-parts":[[2019,10,22]],"date-time":"2019-10-22T03:05:44Z","timestamp":1571713544000},"page":"48-56","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Phase I\/II multisite trial of optimally dosed clofarabine and low\u2010dose TBI for hematopoietic cell transplantation in acute myeloid leukemia"],"prefix":"10.1002","volume":"95","author":[{"given":"Elizabeth F.","family":"Krakow","sequence":"first","affiliation":[{"name":"Clinical Research Division Fred Hutchinson Cancer Research Center  Seattle Washington"},{"name":"Department of Medicine University of Washington  Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boglarka","family":"Gyurkocza","sequence":"additional","affiliation":[{"name":"Clinical Research Division Fred Hutchinson Cancer Research Center  Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barry E.","family":"Storer","sequence":"additional","affiliation":[{"name":"Clinical Research Division Fred Hutchinson Cancer Research Center  Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas R.","family":"Chauncey","sequence":"additional","affiliation":[{"name":"Clinical Research Division Fred Hutchinson Cancer Research Center  Seattle Washington"},{"name":"Department of Medicine University of Washington  Seattle Washington"},{"name":"Bone Marrow Transplant Unit, VA Puget Sound Health Care System  Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeannine S.","family":"McCune","sequence":"additional","affiliation":[{"name":"Clinical Research Division Fred Hutchinson Cancer Research Center  Seattle Washington"},{"name":"Department of Pharmaceutics University of Washington  Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerald P.","family":"Radich","sequence":"additional","affiliation":[{"name":"Clinical Research Division Fred Hutchinson Cancer Research Center  Seattle Washington"},{"name":"Department of Medicine University of Washington  Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle E.","family":"Bouvier","sequence":"additional","affiliation":[{"name":"Clinical Research Division Fred Hutchinson Cancer Research Center  Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elihu H.","family":"Estey","sequence":"additional","affiliation":[{"name":"Clinical Research Division Fred Hutchinson Cancer Research Center  Seattle Washington"},{"name":"Department of Medicine University of Washington  Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rainer","family":"Storb","sequence":"additional","affiliation":[{"name":"Clinical Research Division Fred Hutchinson Cancer Research Center  Seattle Washington"},{"name":"Department of Medicine University of Washington  Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David G","family":"Maloney","sequence":"additional","affiliation":[{"name":"Clinical Research Division Fred Hutchinson Cancer Research Center  Seattle Washington"},{"name":"Department of Medicine University of Washington  Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9767-9739","authenticated-orcid":false,"given":"Brenda M.","family":"Sandmaier","sequence":"additional","affiliation":[{"name":"Clinical Research Division Fred Hutchinson Cancer Research Center  Seattle Washington"},{"name":"Department of Medicine University of Washington  Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,11,8]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"SEER Stat Fact Sheets: Acute Myeloid Leukemia (AML). 2019.https:\/\/seer.cancer.gov\/statfacts\/html\/amyl.html. 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