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Clofarabine + cytarabine is a combination chemotherapy regimen primarily used for the treatment of acute myeloid leukemia (AML), especially in patients with de novo, relapsed, or refractory disease[1][3][8]. Clofarabine is a second-generation deoxyadenosine analog designed to combine the properties of fludarabine and cladribine while minimizing neurotoxicity[1]. It acts by inhibiting ribonucleotide reductase and DNA polymerase α, leading to depletion of intracellular deoxynucleotide triphosphate pools and inhibition of DNA synthesis[6]. Cytarabine is a pyrimidine nucleoside analog that inhibits DNA synthesis by being incorporated into DNA during the S phase of the cell cycle and interfering with DNA polymerases[2][5]. The combination exploits biochemical modulation—clofarabine enhances intracellular retention and activity of cytarabine. This regimen has also been used as conditioning therapy before allogeneic bone marrow transplantation in AML patients[1].
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