| Title | | | Author(s) | Lee SR, Yang DH, Ahn JS, Kim YK, Lee JJ, Choi YJ, Shin HJ, Chung JS, Cho YY, Chae YS, Kim JG, Sohn SK, Kim HJ | | Institution | Blood and Marrow Transplant Center, Hwasun, Korea. | | Source | J Korean Med Sci 2009 Jun; 24(3):498-503. | | Abstract | A refractory and resistant disease to conventional induction chemotherapy and relapsed disease are considered as the most important adverse prognostic factors for acute myeloid leukemia (AML). Sixty-one patients (median age, 33.6 yr) with relapsed or refractory AML were treated with the FLAG regimen that consisted of fludarabine (30 mg/m(2), days 1-5), cytarabine (2.0 g/m(2), days 1-5) and granulocyte colony-stimulating factor. Of the treated patients 29 patients (47.5%) achieved complete remission (CR). Higher CR rates were observed for patients with a first or second relapse as compared to patients with a primary refractory response or relapse after stem cell transplantation (HSCT). There was a significant difference in the response rates according to the duration of leukemia-free survival (pre-LFS) before chemotherapy (P=0.05). The recovery time of both neutrophils (>/=500/microL) and platelets (>/=20,000/microL) required a median of 21 and 18 days, respectively. Treatment-related mortality (TRM) occurred in seven patients (11.4%), of which 71.4% of TRM was caused by an invasive aspergillosis infection. After achieving CR, 18 patients underwent consolidation chemotherapy and six patients underwent allogeneic HSCT. In conclusion, FLAG chemotherapy without idarubicin is a relatively effective and well-tolerated regimen for relapsed or refractory AML and the use of FLAG chemotherapy has allowed intensive post-remission therapy including HSCT. | | Language | ENG | | Pub Type(s) | JOURNAL ARTICLE
| | PubMed ID | 19543516 |
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