ArticleBlood and lymphatic cancer : targets and therapy2026
Efficacy and Safety of CLAG-Based Sequential Conditioning Followed by Allogeneic Hematopoietic Stem Cell Transplantation in Non-Remission Relapsed or Refractory Acute Leukemia.
Article in Blood and lymphatic cancer : targets and therapy, 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
Background: The optimal bridge-to-transplant strategy for patients with relapsed or refractory (R/R) acute leukemia who remain in non-remission (NR) is undefined. We evaluated the strategy-level use of CLAG (cladribine, cytarabine, and granulocyte colony-stimulating factor) as part of sequential conditioning, rather than as stand-alone salvage therapy, before allogeneic hematopoietic stem cell transplantation (allo-HSCT). Methods: This single-center retrospective case series included nine consecutive patients with R/R acute leukemia and bone marrow blasts ≥10% who underwent CLAG-based sequential conditioning followed by allo-HSCT between January 2021 and July 2023. Engraftment, transplant-related complications, non-relapse mortality, relapse, disease-free survival (DFS), and overall survival (OS) were evaluated descriptively; no control group was available. Results: All nine patients achieved neutrophil and platelet engraftment and complete donor chimerism at approximately day +30. At a routine MFC/NGF analytical sensitivity of 10 Conclusion: In this highly selected cohort of nine NR patients, CLAG-based sequential conditioning permitted engraftment without non-relapse mortality, but infection and relapse remained frequent. These findings support technical feasibility only and should be regarded as exploratory and hypothesis-generating; efficacy or superiority cannot be established without larger prospective, multicenter, controlled studies.
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