{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T21:19:08Z","timestamp":1793999948815,"version":"4.8.0"},"reference-count":13,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T00:00:00Z","timestamp":1763596800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Oncol Pharm Pract"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Intensive chemotherapy combinations with venetoclax are being used more frequently for acute myeloid leukemia (AML). In May 2022, a critical shortage of fludarabine prompted cladribine substitution at several institutions in the United States. FLAG-Ida-Ven and CLIA-Ven are similar IC regimens using different purine analogues, potentially with different efficacy and toxicity. To describe the patient population, outcomes, and toxicities of patients receiving FLAG-Ida-Ven and CLIA-Ven.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources<\/jats:title>\n                    <jats:p>A retrospective analysis of patients over 18 years with AML who received FLAG-Ida-Ven or CLIA-Ven for relapsed\/refractory AML (R\/R AML) at the City of Hope between December 2020 and January 2023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Summary<\/jats:title>\n                    <jats:p>There were 31 patients who received FLAG-Ida-Ven; 8 patients received CLIA-Ven. Patients were identified using ICD-10 code for AML and documented administration of medications. Most patients included were male with de novo AML with ELN adverse risk AML. Median age was 53 years (20\u201378) for FLAG-Ida-Ven and 47.5 years (23\u201369) for CLIA-Ven. Prior exposure to venetoclax based therapy was common (61.3% vs 50%). The ORR (overall response rate) in FLAG-Ida-Ven and CLIA-Ven was 46.7% and 75%, of which 86% vs 83% were MRD negative, respectively. There were 42% (n\u2009=\u200913) and 50% (n\u2009=\u20094) of patients who were able to proceed to allogeneic stem cell transplant in the FLAG-Ida-Ven and CLIA-Ven with median time to transplant being 89 vs 132 days respectively.<\/jats:p>\n                    <jats:p>Regarding safety, CLIA-Ven had a higher incidence of grade 3 or 4 non-hematologic adverse events, 6% vs 50% respectively. Survival from therapy initiation at 6 months was 48.4% vs 75%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Consistent with the literature, it appears that the activity between FLAG-Ida-Ven and CLIA-Ven are comparable, however FLAG-Ida-Ven may have a more tolerable safety profile.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10781552251396885","type":"journal-article","created":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T17:44:54Z","timestamp":1763660694000},"page":"555-559","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["FLAG-Ida-Venetoclax vs CLIA-venetoclax for relapsed and refractory AML during a fludarabine shortage: A single center experience"],"prefix":"10.1177","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1175-3564","authenticated-orcid":false,"given":"Jose","family":"Tinajero","sequence":"first","affiliation":[{"name":"City of Hope National Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-8848-2851","authenticated-orcid":false,"given":"Dat","family":"Ngo","sequence":"additional","affiliation":[{"name":"City of Hope National Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2512-8345","authenticated-orcid":false,"given":"Brian","family":"Lee","sequence":"additional","affiliation":[{"name":"City of Hope National Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hoim","family":"Kim","sequence":"additional","affiliation":[{"name":"City of Hope National Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Ball","sequence":"additional","affiliation":[{"name":"City of Hope National Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Koller","sequence":"additional","affiliation":[{"name":"City of Hope National Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Idoroenyi","family":"Amanam","sequence":"additional","affiliation":[{"name":"City of Hope National Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hoda","family":"Pourhassan","sequence":"additional","affiliation":[{"name":"City of Hope National Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haris","family":"Ali","sequence":"additional","affiliation":[{"name":"City of Hope National Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salman","family":"Otoukesh","sequence":"additional","affiliation":[{"name":"City of Hope National Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amandeep","family":"Salhotra","sequence":"additional","affiliation":[{"name":"City of Hope National Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Blackmon","sequence":"additional","affiliation":[{"name":"City of Hope National Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karamjeet","family":"Sandhu","sequence":"additional","affiliation":[{"name":"City of Hope National Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,11,20]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-15-3057"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1080\/10428194.2017.1283032"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.26601"},{"key":"e_1_3_3_5_2","unstructured":"American Society of Health-System Pharmacies. Fludarabine injection. Available at:https:\/\/www.ashp.org\/drug-shortages\/current-shortages\/drug-shortage-detail.aspx?id=622&loginreturnUrl=SSOCheckOnly. Accessed December 19 2022."},{"key":"e_1_3_3_6_2","doi-asserted-by":"crossref","DOI":"10.1016\/S2352-3026(21)00192-7","article-title":"Venetoclax plus intensive chemotherapy with cladribine, idarubicin, and cytarabine in patients with newly diagnosed acute myeloid leukaemia or high-risk myelodysplastic syndrome: a cohort from a single-centre, single-arm, phase 2 trial.","volume":"8","author":"Kadia TM","year":"2021","unstructured":"Kadia TM, et al. Venetoclax plus intensive chemotherapy with cladribine, idarubicin, and cytarabine in patients with newly diagnosed acute myeloid leukaemia or high-risk myelodysplastic syndrome: a cohort from a single-centre, single-arm, phase 2 trial. The Lancet. Haematology 2021; 8,8: e552\u2013e561.","journal-title":"The Lancet. 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