{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,26]],"date-time":"2026-04-26T14:12:19Z","timestamp":1777212739283,"version":"3.51.4"},"reference-count":52,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2021,8,20]],"date-time":"2021-08-20T00:00:00Z","timestamp":1629417600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Institute of Hematology and Transfusion Medicine in Warsaw","award":["No grant number"],"award-info":[{"award-number":["No grant number"]}]},{"name":"Polish Adult Leukemia Group","award":["No grant number"],"award-info":[{"award-number":["No grant number"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Acute myeloid leukemia (AML) in older unfit patients is a therapeutic challenge for clinical hematologists. We evaluated the efficacy and safety of a novel low-intensity regimen consisting of low-dose cytarabine and cladribine (LD-AC+cladribine) in first-line treatment of elderly (\u226560 years) AML patients not eligible for intensive chemotherapy (IC) who had either the Eastern Cooperative Oncology Group performance status (ECOG PS) \u22652 or the hematopoietic cell transplantation comorbidity index (HCT-CI) score \u22653. The induction phase included two cycles of LD-AC+cladribine. Patients who achieved at least partial remission (PR) received maintenance treatment with LD-AC alone. Overall, 117 patients with a median age of 70 years were enrolled. Adverse cytogenetics, ECOG PS \u22652 and HCT-CI score \u22653 was observed in 43.5%, 60%, and 58% of patients, respectively. The response rate (\u2265PR) was 54% (complete remission [CR], 32%; CR with incomplete hematologic recovery [CRi], 5%). A median overall survival (OS) was 21 and 8.8 months in CR\/CRi and PR group, respectively. Advanced age (\u226575 years) and adverse cytogenetics had a negative impact on OS. The 56-day mortality rate was 20.5%. In conclusion, LD-AC+cladribine is a beneficial therapeutic option with a predictable safety profile in elderly AML patients not eligible for IC.<\/jats:p>","DOI":"10.3390\/cancers13164189","type":"journal-article","created":{"date-parts":[[2021,8,20]],"date-time":"2021-08-20T08:44:45Z","timestamp":1629449085000},"page":"4189","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Cladribine Combined with Low-Dose Cytarabine as Frontline Treatment for Unfit Elderly Acute Myeloid Leukemia Patients: Results from a Prospective Multicenter Study of Polish Adult Leukemia Group (PALG)"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9482-4099","authenticated-orcid":false,"given":"Bo\u017cena Katarzyna","family":"Budziszewska","sequence":"first","affiliation":[{"name":"Department of Hematology, Institute of Hematology and Transfusion Medicine, 02-776 Warsaw, Poland"},{"name":"Centre of Postgraduate Medical Education, 01-813 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8394-5346","authenticated-orcid":false,"given":"Aleksander","family":"Salomon-Perzy\u0144ski","sequence":"additional","affiliation":[{"name":"Department of Hematology, Institute of Hematology and Transfusion Medicine, 02-776 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katarzyna","family":"Pruszczyk","sequence":"additional","affiliation":[{"name":"Department of Hematology, Institute of Hematology and Transfusion Medicine, 02-776 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5029-9173","authenticated-orcid":false,"given":"Joanna","family":"Barankiewicz","sequence":"additional","affiliation":[{"name":"Department of Hematology, Institute of Hematology and Transfusion Medicine, 02-776 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agnieszka","family":"Pluta","sequence":"additional","affiliation":[{"name":"Department of Hematology, Medical University of Lodz, 93-513 Lodz, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grzegorz","family":"Helbig","sequence":"additional","affiliation":[{"name":"Department of Hematology and Bone Marrow Transplantation, School of Medicine in Katowice, Medical University of Silesia, 40-032 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Janowska","sequence":"additional","affiliation":[{"name":"Department of Hematology, Medical University of Lodz, 93-513 Lodz, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marta","family":"Kuydowicz","sequence":"additional","affiliation":[{"name":"Department of Hematology, Medical University of Lodz, 93-513 Lodz, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6629-8626","authenticated-orcid":false,"given":"\u0141ukasz","family":"Bo\u0142kun","sequence":"additional","affiliation":[{"name":"Department of Hematology, Medical University of Bialystok, 15-276 Bialystok, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaros\u0142aw","family":"Piszcz","sequence":"additional","affiliation":[{"name":"Department of Hematology, Medical University of Bialystok, 15-276 Bialystok, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8691-4310","authenticated-orcid":false,"given":"El\u017cbieta","family":"Patkowska","sequence":"additional","affiliation":[{"name":"Department of Hematology, Institute of Hematology and Transfusion Medicine, 02-776 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marzena","family":"W\u0105tek","sequence":"additional","affiliation":[{"name":"Department of Hematology, Institute of Hematology and Transfusion Medicine, 02-776 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Piotr","family":"Ma\u0142ecki","sequence":"additional","affiliation":[{"name":"Department of Hematology and Cancer Prevention, Faculty of Health Sciences, Medical University of Silesia, 40-055 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sylwia","family":"Ko\u015bcio\u0142ek-Zg\u00f3dka","sequence":"additional","affiliation":[{"name":"Center of Oncology, Hematology Department, 25-734 Kielce, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edyta","family":"Cichocka","sequence":"additional","affiliation":[{"name":"Hematology Department, Nicolaus Copernicus Hospital, 87-100 Torun, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0595-5864","authenticated-orcid":false,"given":"Grzegorz","family":"Charli\u0144ski","sequence":"additional","affiliation":[{"name":"Warmian-Masurian Cancer Center of The Ministry of The Interior and Administration\u2019s Hospital, Department of Hematology, 10-228 Olsztyn, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Irga-Staniukiewicz","sequence":"additional","affiliation":[{"name":"Department of Hematology and Transplantology, Medical University of Gdansk, 80-952 Gdansk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan Maciej","family":"Zaucha","sequence":"additional","affiliation":[{"name":"Department of Hematology and Transplantology, Medical University of Gdansk, 80-952 Gdansk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1593-8005","authenticated-orcid":false,"given":"Agnieszka","family":"Piekarska","sequence":"additional","affiliation":[{"name":"Department of Hematology and Transplantology, Medical University of Gdansk, 80-952 Gdansk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomasz","family":"Gromek","sequence":"additional","affiliation":[{"name":"Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, 20-081 Lublin, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marek","family":"Hus","sequence":"additional","affiliation":[{"name":"Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, 20-081 Lublin, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karol","family":"W\u00f3jcik","sequence":"additional","affiliation":[{"name":"Hematology Department, Rydygier Memorial Hospital, 31-826 Krakow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ma\u0142gorzata","family":"Ra\u017any","sequence":"additional","affiliation":[{"name":"Hematology Department, Rydygier Memorial Hospital, 31-826 Krakow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariola","family":"S\u0119dzimirska","sequence":"additional","affiliation":[{"name":"Lower Silesian Centrum for Cellular Transplantation, 53-439 Wroclaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bartosz","family":"Pu\u0142a","sequence":"additional","affiliation":[{"name":"Department of Hematology, Institute of Hematology and Transfusion Medicine, 02-776 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sebastian","family":"Giebel","sequence":"additional","affiliation":[{"name":"Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, 44-102 Gliwice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2644-1050","authenticated-orcid":false,"given":"Sebastian","family":"Grosicki","sequence":"additional","affiliation":[{"name":"Department of Hematology and Cancer Prevention, Faculty of Health Sciences, Medical University of Silesia, 40-055 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agnieszka","family":"Wierzbowska","sequence":"additional","affiliation":[{"name":"Department of Hematology, Medical University of Lodz, 93-513 Lodz, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ewa","family":"Lech-Mara\u0144da","sequence":"additional","affiliation":[{"name":"Department of Hematology, Institute of Hematology and Transfusion Medicine, 02-776 Warsaw, Poland"},{"name":"Centre of Postgraduate Medical Education, 01-813 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,8,20]]},"reference":[{"key":"ref_1","unstructured":"(2021, April 11). 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