ArticleAnnals of hematology2026
2g/m2 Ara-c induced more favorable outcome than 1g/m2 Ara-c in CLAG treatment for refractory or relapsed acute myeloid leukemia without increase toxicity: a multicenter propensity score matching analysis.
Article in Annals of hematology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
This study compared the efficacy and toxicity of two cytarabine doses (1 g/m² vs. 2 g/m²) within the CLAG regimen for relapsed/refractory acute myeloid leukemia (R/R AML) patients. In this multicenter retrospective analysis, 183 R/R AML patients received the CLAG regimen (86 in the 1 g/m² group; 97 in the 2 g/m² group). After excluding 12 unevaluable cases, 171 patients (82 vs. 89) were analyzed. Propensity score matching (PSM) created 102 well-balanced pairs. Endpoints included complete remission rate (CRR), overall remission rate (ORR), overall survival (OS), leukemia-free survival (LFS), and toxicity. A significantly higher complete response (CR) rate was observed in the 2 g/m² group compared with the 1 g/m² group, both in the overall population (71.9% vs. 53.7%; p = 0.013) and in the propensity score-matched (PSM) cohort (68.6% vs. 49.0%; p = 0.044). The 2 g/m² regimen was also associated with superior 2-year overall survival (OS) in the overall analysis (46.2% vs. 13.4%; p = 0.004), with a strong trend toward significance in the PSM cohort (33.9% vs. 13.7%; p = 0.07). Toxicity profiles were similar except for a longer neutropenia duration in the 2 g/m² group (18 vs. 16 days, p = 0.003). Allogeneic HSCT post-remission was a significant predictor for improved OS. The 2 g/m² cytarabine dose in the CLAG regimen yielded superior response rates and survival outcomes in R/R AML patients eligible for transplant bridging, without increasing significant toxicity.
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