期刊
BLOOD
卷 109, 期 12, 页码 5136-5142出版社
AMER SOC HEMATOLOGY
DOI: 10.1182/blood-2006-11-056754
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资金
- NCI NIH HHS [U10 CA047559, CA47559, CA33601, U10 CA047577, N01 CA013612, CA47577, CA32291, U10 CA020319, CA41287, U10 CA033601, U10 CA031946, CA20319, U10 CA032291, U10 CA041287, CA31946, U10 CA013612] Funding Source: Medline
Nelarabine (5061.1178) is a soluble pro-drug of 9-beta-D-arabinofuranosylguanine(ara-G), a deoxyguanosine derivative. We treated 26 patients with T-cell acute lymphoblastic leukemia (T-ALL) and 13 with T-cell lymphoblastic lymphoma (T-LBL) with nelarabine. All patients were refractory to at least one multiagent regimen or had relapsed after achieving a complete remission. Nelarabine was administered on an alternate day schedule (days 1, 3, and 5) at 1.5 g/m(2)/day. Cycles were repeated every 22 days. The median age was 34 years (range, 16-66 years); 32 (82%) patients were male. The rate of complete remission was 31% (95% confidence interval [CI], 17%, 48%) and the overall response rate was 41% (95% CI, 26%, 58%). The principal toxicity was grade 3 or 4 neutropenia and thrombocytopenia, occurring in 37% and 26% of patients, respectively. There was only one grade 4 adverse event of the nervous system, which was a reversible depressed level of consciousness. The median disease-free survival (DFS) was 20 weeks (95% CI, 11, 56), and the median overall survival was 20 weeks (95% CI, 13, 36). The 1-year overall survival was 28% (95% CI, 15%, 43%). Nelarabine is well tolerated and has significant antitumor activity in relapsed or refractory T-ALL and T-LBL.
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