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Clofarabine + cytarabine + idarubicin is a combination chemotherapy regimen used primarily for the treatment of acute myeloid leukemia (AML), particularly in newly diagnosed patients and those with high-risk features. Clofarabine is a second-generation purine nucleoside analogue that inhibits ribonucleotide reductase and DNA polymerase, leading to depletion of deoxynucleoside triphosphates and inhibition of DNA synthesis[6]. Cytarabine is an antimetabolite that interferes with DNA synthesis by being incorporated into DNA and inhibiting DNA polymerases, specifically targeting cells in the S phase[8]. Idarubicin is an anthracycline antibiotic that intercalates into DNA, inhibiting topoisomerase II and generating free radicals, resulting in cytotoxicity. The combination has demonstrated synergistic activity, improved response rates compared to standard regimens (such as idarubicin plus cytarabine alone), and manageable toxicity profiles in clinical trials for AML[1][2][5].
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