{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T09:59:21Z","timestamp":1780394361979,"version":"3.54.1"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,2,3]],"date-time":"2023-02-03T00:00:00Z","timestamp":1675382400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012226","name":"Fundamental Research Funds for the Central Universities","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100012226","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:p>This is a small phase I study examining the safety and efficacy of a cladribine (CLAD)-containing conditioning regimen prior to autologous hematopoietic stem cell transplantion (auto-HSCT) for patients with acute myeloid leukemia (AML). All patients, aged 15\u201354\u00a0years (median 32\u00a0years), had favorable\/intermediate risk AML (n = 20) or acute promyelocytic leukemia (APL; n = 2) and no evidence of minimal residual disease (MRD) prior to transplantation. Fourteen of the 22 patients received the conditioning regimen as follows: busulfan (Bu) + cyclophosphamide (Cy) + CLAD + cytarabine (Ara-c) or idarubicin. The conditioning regimen of 8 patients was without Cy nor idarubicin to reducing adverse cardiac reaction: the regimen of Bu + CLAD+ Ara-c for 6 patients; and the regimen of Bu + melphalan + CLAD + Ara-c for the other 2 patients. All 22 AML patients received peripheral blood stem cell transplantation. The number of infused mononuclear cells and CD34<jats:sup>+<\/jats:sup> cells was 10.00 (2.88\u201320.97) \u00d7 10<jats:sup>8<\/jats:sup>\/kg and 1.89 (1.52\u201310.44) \u00d7 10<jats:sup>6<\/jats:sup>\/kg, respectively. Hematopoietic reconstitution was achieved in all patients, with a median time of 13 (10\u201334) days for neutrophils and 28 (14\u2013113) days for platelets. Two patients suffered from pulmonary infection, 4 patients suffered from septicemia during the neutropenic stage, and the others suffered from infection or gastrointestinal reaction without exceeding grade 3 after conditioning, which were all alleviated by anti-infection and other supportive treatment. None of the patients died of transplantation-related complications. At a median follow-up of 29.5 (ranging from 4.0 to 60.0) months, three patients relapsed after auto-HSCT at a median time of 6 (ranging from 0.5 to 10.0) months. One patient died due to relapse at 18\u00a0months after auto-HSCT. The remaining 21 patients were all alive, including 19 patients with negative MRD. The other 2 patients achieved negative MRD after allogeneic HSCT or chemotherapy. The estimated 2-year survival, relapse, and Leukemia-free survival rates were 94.1 \u00b1 5.7%, 14.7 \u00b1 7.9% and 85.3 \u00b1 7.9%, respectively. A CLAD-combination conditioning regimen is efficient and safe for auto-HSCT, indicating an effective approach for AML treatment.<\/jats:p>","DOI":"10.3389\/fphar.2023.1014306","type":"journal-article","created":{"date-parts":[[2023,2,3]],"date-time":"2023-02-03T06:13:04Z","timestamp":1675404784000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Safety and efficacy of a modified busulfan\/cyclophosphamide conditioning regimen incorporating cladribine for autologous hematopoietic stem cell transplantation in acute myeloid leukemia"],"prefix":"10.3389","volume":"14","author":[{"given":"Yuan-Yuan","family":"Shi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeng-Yan","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gui-Xin","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming-Zhe","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Si-Zhou","family":"Feng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rong-Li","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Er-Lie","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,2,3]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"870","DOI":"10.1007\/s12094-017-1798-8","article-title":"Comparison of clinical remission and survival between CLAG and FLAG induction chemotherapy in patients with refractory or relapsed acute myeloid leukemia: A prospective cohort study","volume":"20","author":"Bao","year":"2018","journal-title":"Clin. Transl. Oncol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1053\/j.seminhematol.2018.09.001","article-title":"The emerging role of measurable residual disease detection in AML in morphologic remission","volume":"56","author":"Buccisano","year":"2019","journal-title":"Semin. Hematol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1041","DOI":"10.1038\/leu.2014.332","article-title":"Comparative therapeutic value of post-remission approaches in patients with acute myeloid leukemia aged 40-60 years","volume":"29","author":"Cornelissen","year":"2015","journal-title":"Leukemia"},{"key":"B4","doi-asserted-by":"publisher","first-page":"424","DOI":"10.1182\/blood-2016-08-733196","article-title":"Diagnosis and management of AML in adults: 2017 ELN recommendations from an international expert panel","volume":"129","author":"Dohner","year":"2017","journal-title":"Blood"},{"key":"B5","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1002\/ajh.23862","article-title":"Revisiting the role of cladribine in acute myeloid leukemia: An improvement on past accomplishments or more old news?","volume":"90","author":"Freyer","year":"2015","journal-title":"Am. J. Hematol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1016\/j.leukres.2016.12.001","article-title":"Consolidation with autologous stem cell transplantation in first remission is safe and effective in AML patients above 65 years","volume":"53","author":"Heini","year":"2017","journal-title":"Leuk. Res."},{"key":"B7","doi-asserted-by":"publisher","first-page":"469","DOI":"10.1007\/s12253-017-0266-7","article-title":"Long-term outcome of autologous hematopoietic stem cell transplantation (AHSCT) for acute myeloid leukemia (AML)- single center retrospective analysis","volume":"24","author":"Helbig","year":"2018","journal-title":"Pathol. Oncol. Res."},{"key":"B8","doi-asserted-by":"publisher","first-page":"2441","DOI":"10.1200\/JCO.2011.37.1286","article-title":"Cladribine, but not fludarabine, added to daunorubicin and cytarabine during induction prolongs survival of patients with acute myeloid leukemia: A multicenter, randomized phase III study","volume":"30","author":"Holowiecki","year":"2012","journal-title":"J. Clin. Oncol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"185","DOI":"10.3324\/haematol.2012.062059","article-title":"Autologous blood cell transplantation versus HLA-identical sibling transplantation for acute myeloid leukemia in first complete remission: A registry study from the center for international blood and marrow transplantation research","volume":"98","author":"Keating","year":"2013","journal-title":"Haematologica"},{"key":"B10","doi-asserted-by":"publisher","first-page":"645","DOI":"10.1038\/bmt.2015.349","article-title":"Comparable outcomes between autologous and allogeneic transplant for adult acute myeloid leukemia in first CR","volume":"51","author":"Mizutani","year":"2016","journal-title":"Bone Marrow Transpl."},{"key":"B11","doi-asserted-by":"publisher","first-page":"1974","DOI":"10.1016\/j.bbmt.2016.08.014","article-title":"Multigene measurable residual disease assessment improves acute myeloid leukemia relapse risk stratification in autologous hematopoietic cell transplantation","volume":"22","author":"Mul\u00e9","year":"2016","journal-title":"Biol. Blood Marrow Transpl."},{"key":"B12","volume-title":"Common Terminology criteria for adverse Events (CTCAE)","year":"2017"},{"key":"B13","doi-asserted-by":"publisher","first-page":"3121","DOI":"10.1002\/cncr.32354","article-title":"Current treatment strategies for measurable residual disease in patients with acute myeloid leukemia","volume":"125","author":"Percival","year":"2019","journal-title":"Cancer"},{"key":"B14","doi-asserted-by":"publisher","first-page":"665","DOI":"10.3390\/jcm4040665","article-title":"Current approaches in the treatment of relapsed and refractory acute myeloid leukemia","volume":"4","author":"Ramos","year":"2015","journal-title":"J. Clin. Med."},{"key":"B15","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1016\/j.leukres.2014.01.005","article-title":"Cladribine in the treatment of acute myeloid leukemia","volume":"38","author":"Robak","year":"2014","journal-title":"Leuk. Res."},{"key":"B16","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1038\/bmt.2016.233","article-title":"Autologous stem cell transplantation is still a valid option in good- and intermediate-risk AML: A GITMO survey on 809 patients autografted in first complete remission","volume":"52","author":"Saraceni","year":"2017","journal-title":"Bone Marrow Transpl."},{"key":"B17","first-page":"97","volume-title":"Criteria for diagnosis and efficacy of hematological diseases","author":"Shen","year":"2018"},{"key":"B18","doi-asserted-by":"publisher","first-page":"738","DOI":"10.4149\/neo_2017_512","article-title":"Autologous hematopoietic stem cell transplantation for acute myeloid leukemia - single center experience","volume":"64","author":"Simancikova","year":"2017","journal-title":"Neoplasma"},{"key":"B19","doi-asserted-by":"publisher","first-page":"444","DOI":"10.1016\/j.clml.2012.07.004","article-title":"Comparison of autologous hematopoietic cell transplantation and chemotherapy as postremission treatment in non-M3 acute myeloid leukemia in first complete remission","volume":"12","author":"Usuki","year":"2012","journal-title":"Clin. Lymphoma Myeloma Leuk."},{"key":"B20","doi-asserted-by":"publisher","first-page":"3429","DOI":"10.1182\/blood.v84.10.3429.3429","article-title":"Therapeutic and neurotoxic effects of 2-chlorodeoxyadenosine in adults with acute myeloid leukemia","volume":"84","author":"Vahdat","year":"1994","journal-title":"Blood"},{"key":"B21","doi-asserted-by":"publisher","first-page":"937","DOI":"10.1182\/blood-2009-03-209262","article-title":"The 2008 revision of the world health organization (WHO) classification of myeloid neoplasms and acute leukemia: Rationale and important changesWHOclassification of myeloid neoplasms and acute leukemia: Rationale and important changes","volume":"114","author":"Vardiman","year":"2009","journal-title":"Blood"},{"key":"B22","doi-asserted-by":"publisher","first-page":"6037","DOI":"10.1182\/blood-2011-07-370247","article-title":"Autologous peripheral blood stem cell transplantation for acute myeloid leukemia","volume":"118","author":"Vellenga","year":"2011","journal-title":"Blood"},{"key":"B23","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1016\/j.leukres.2017.01.026","article-title":"Combination of cytogenetic classification and MRD status correlates with outcome of autologous versus allogeneic stem cell transplantation in adults with primary acute myeloid leukemia in first remission","volume":"55","author":"Yao","year":"2017","journal-title":"Leuk. Res."}],"container-title":["Frontiers in Pharmacology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphar.2023.1014306\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,3]],"date-time":"2023-02-03T06:13:08Z","timestamp":1675404788000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphar.2023.1014306\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,3]]},"references-count":23,"alternative-id":["10.3389\/fphar.2023.1014306"],"URL":"https:\/\/doi.org\/10.3389\/fphar.2023.1014306","relation":{},"ISSN":["1663-9812"],"issn-type":[{"value":"1663-9812","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,3]]},"article-number":"1014306"}}