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Case Reports
. 2020 Nov 26;8(22):5603-5610.
doi: 10.12998/wjcc.v8.i22.5603.

CLAG-M chemotherapy followed by umbilical cord blood stem cell transplantation for primary refractory acute myeloid leukaemia in a child: A case report

Jie Huang  1 , Xiao-Yun Yang  1 , Liu-Cheng Rong  1 , Yao Xue  1 , Jun Zhu  1 , Yong-Jun Fang  2
Affiliations
Case Reports

CLAG-M chemotherapy followed by umbilical cord blood stem cell transplantation for primary refractory acute myeloid leukaemia in a child: A case report

Jie Huang et al. World J Clin Cases. .

Abstract

Background: The prognosis of paediatric primary refractory/relapsed acute myeloid leukaemia (R/R AML) remains poor. Intensive therapy is typically used as salvage treatment for those with R/R AML. No data are currently available about the use of the CLAG-M protocol as salvage therapy in paediatric patients with R/R AML.

Case summary: An 8-year-old patient was diagnosed with acute myeloid leukaemia by bone marrow morphology and immunophenotype. The patient showed poor response to two cycles of induction therapy with 60% blast cells in the bone marrow after the second induction cycle. The patient achieved complete remission after being treated with the CLAG-M protocol as salvage therapy before undergoing umbilical cord blood stem cell transplantation. Morphological complete remission with haematological recovery has hitherto been maintained over 4 mo. Abnormal gene mutations detected at diagnosis were undetectable after haematopoietic stem cell transplantation.

Conclusion: Here we present a paediatric patient with primary refractory acute myeloid leukaemia who was successfully treated with the CLAG-M protocol. Given the positive results of the presented patient, large-scale clinical studies are required to assess the role of the CLAG-M protocol in the salvage treatment of refractory or relapsed AML in childhood.

Keywords: Acute myeloid leukaemia; CLAG-M protocol; Case report; Refractory; Salvage therapy; child.

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Conflict of interest statement

Conflict-of-interest statement: The authors state there is no conflict of interest.

Figures

Figure 1
Figure 1
Blast cells in bone marrow at diagnosis.
Figure 2
Figure 2
CLAG-M protocol. Ara-C: Cytarabine; BM: Bone marrow; G-CSF: Granulocyte colony-stimulating factor; MIT: Mitoxantrone.
Figure 3
Figure 3
Conditioning protocol for umbilical cord blood stem cell transplantation. Ara-C: Cytarabine 1.5 g/m2 intravenously (q12 h, day -10 to day -9); Bu: Busulfan 0.8 mg/kg (q6 h × 12, day -9 to day -7); CTX: Cyclophosphamide 50 mg/kg intravenously (qd × 4 d); Flu: Fludarabine 30 mg/m2 (qd × 6 d).
See this image and copyright information in PMC

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