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Clofarabine + cytarabine + mitoxantrone is a combination chemotherapy regimen, often referred to as CLAM, used primarily in the treatment of relapsed or refractory acute myeloid leukemia (AML). Clofarabine is a purine nucleoside analog that inhibits DNA synthesis and repair by incorporating into DNA and inhibiting ribonucleotide reductase. Cytarabine is a pyrimidine nucleoside analog that interferes with DNA synthesis during the S-phase of the cell cycle. Mitoxantrone is an anthracenedione antitumor antibiotic that intercalates into DNA, causing crosslinks and strand breaks, and inhibits topoisomerase II. The combination has demonstrated high response rates in clinical studies for patients with relapsed/refractory AML, enabling many to proceed to allogeneic hematopoietic stem cell transplantation[1][4][6]. The regimen aims to maximize anti-leukemic efficacy while maintaining manageable toxicity.
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