{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T11:07:11Z","timestamp":1787828831682,"version":"build-2784847793"},"reference-count":16,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,12,2]],"date-time":"2022-12-02T00:00:00Z","timestamp":1669939200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2023,2,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Patients with higher risk chronic myelomonocytic leukemia (CMML) have limited therapeutic options beyond hydroxyurea and hypomethylating agents (HMAs). Regimens based on a backbone of cladribine (CLAD), low\u2010dose cytarabine (LDAC), and an HMA are effective low\u2010intensity therapies for acute myeloid leukemia (AML).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The authors conducted a retrospective chart review to evaluate the efficacy of CLAD\/LDAC\/HMA in CMML and secondary acute myeloid leukemia (sAML) arising from CMML. Responses were evaluated according to the 2006 International Working Group criteria for CMML and the 2017 European LeukemiaNet criteria for AML. The overall survival (OS), leukemia\u2010free survival (LFS), and duration of response were evaluated with the Kaplan\u2013Meier method. Patients were stratified on the basis of prior HMA exposure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The authors identified 21 patients with CMML (eight with HMA\u2010naive CMML and 13 with HMA\u2010failure CMML) and 33 patients with sAML (11 with HMA\u2010naive sAML and 22 with HMA\u2010failure sAML) treated with CLAD\/LDAC\/HMA\u2010based regimens. The CMML cohort was enriched for high\u2010risk features (proliferative type, elevated blasts, and RAS\/MAPK mutations). The overall response rate was 33% in CMML (50% in HMA\u2010naive CMML and 23% in HMA\u2010failure CMML) and 48% in sAML (82% in HMA\u2010naive sAML and 32% in HMA\u2010failure sAML). The median OS was 14.4, 8.8, 42.9, and 2.9\u00a0months for HMA\u2010naive CMML, HMA\u2010failure CMML, HMA\u2010naive sAML, and HMA\u2010failure sAML, respectively. The median LFS was 14.4 and 3.9\u00a0months for HMA\u2010naive CMML and HMA\u2010failure CMML, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>CLAD\/LDAC\/HMA\u2010based regimens are effective in a subset of patients with higher risk CMML and sAML arising from CMML who have not previously experienced HMA failure. These findings must be confirmed in prospective studies.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.34564","type":"journal-article","created":{"date-parts":[[2022,12,2]],"date-time":"2022-12-02T05:47:12Z","timestamp":1669960032000},"page":"560-568","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["A retrospective study of cladribine and low\u2010dose cytarabine\u2013based regimens for the treatment of chronic myelomonocytic leukemia and secondary acute myeloid leukemia"],"prefix":"10.1002","volume":"129","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5538-4943","authenticated-orcid":false,"given":"Alexandre","family":"Bazinet","sequence":"first","affiliation":[{"name":"Department of Leukemia The University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faezeh","family":"Darbaniyan","sequence":"additional","affiliation":[{"name":"Department 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MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9003-0390","authenticated-orcid":false,"given":"Courtney D.","family":"DiNardo","sequence":"additional","affiliation":[{"name":"Department of Leukemia The University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gautam","family":"Borthakur","sequence":"additional","affiliation":[{"name":"Department of Leukemia The University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4465-6119","authenticated-orcid":false,"given":"Elias J.","family":"Jabbour","sequence":"additional","affiliation":[{"name":"Department of Leukemia The University of Texas MD Anderson Cancer Center  Houston Texas 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