Nelarabine induces complete remissions in adults with relapsed or refractory T-lineage acute lymphoblastic leukemia or lymphoblastic lymphoma: Cancer and Leukemia Group B study 19801

Daniel J. DeAngelo, Daohai Yu, Jeffrey L. Johnson, Steven E. Coutre, Richard M. Stone, Alison T. Stopeck, Jon P. Gockerman, Beverly S. Mitchell, Frederick R. Appelbaum, Richard A. Larson

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163 Scopus citations

Abstract

Nelarabine (506U78) is a soluble pro-drug of 9-β-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/m2/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.

Original languageEnglish (US)
Pages (from-to)5136-5142
Number of pages7
JournalBlood
Volume109
Issue number12
DOIs
StatePublished - Jun 15 2007

ASJC Scopus subject areas

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

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    DeAngelo, D. J., Yu, D., Johnson, J. L., Coutre, S. E., Stone, R. M., Stopeck, A. T., Gockerman, J. P., Mitchell, B. S., Appelbaum, F. R., & Larson, R. A. (2007). Nelarabine induces complete remissions in adults with relapsed or refractory T-lineage acute lymphoblastic leukemia or lymphoblastic lymphoma: Cancer and Leukemia Group B study 19801. Blood, 109(12), 5136-5142. https://doi.org/10.1182/blood-2006-11-056754