Efficacy and safety of the cladribine, idarubicin, and cytarabine regimen for treating acute myeloid leukemia: a systematic review and single-arm meta-analysis.
Yichen Xu, Shuai Chen, Ruolin Zhang
✦ AI-curated · Sources linked
In 30 seconds
This systematic review and single-arm meta-analysis assessed the efficacy and safety of cladribine, idarubicin, and cytarabine (CIA) for acute myeloid leukemia (AML), separating newly diagnosed (ND) from relapsed/refractory (R/R) disease. In ND AML, the pooled complete remission rate was 72.7% (95% CI: 66.4%-79.0%), and the overall response rate was 80.4% (95% CI: 76.8%-84.0%). For R/R AML, the pooled complete remission estimate was 37.1% (95% CI: 7.5%-66.6%), based on limited evidence. Severe infection was a notable safety concern; the authors advise cautious interpretation.
Key findings
- In ND AML, pooled complete remission was 72.7% (95% CI: 66.4%-79.0%) and overall response was 80.4% (95% CI: 76.8%-84.0%).
- In R/R AML, pooled complete remission was 37.1% (95% CI: 7.5%-66.6%); other efficacy outcomes were not pooled because studies were insufficient.
- In ND AML, pooled severe infection was 59.5% (25.2%-93.8%), while 28-day all-cause mortality was 6.1% (1.1%-11.2%).
Why it matters
The findings provide an evidence summary of CIA outcomes across newly diagnosed and relapsed/refractory AML, while highlighting that response estimates differ by disease status and that severe infections are an important safety issue. These pooled results may inform clinical understanding of the regimen, but the single-arm evidence does not establish comparative benefit over other AML treatments.
What to keep in mind
The review pooled single-arm studies, and the authors note that the number of studies was small. Evidence for R/R AML was particularly limited, with insufficient studies to pool several efficacy outcomes.