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Fludarabine, amsacrine, high-dose cytarabine and 12 Gy total body irradiation followed by allogeneic hematopoietic stem cell transplantation is effective in patients with relapsed or high-risk acute lymphoblastic leukemia.
Bone Marrow Transplant. 2009 Dec; 44(12):785-92.BM

Abstract

In this prospective study, we examined the toxicity and efficacy of an intensified conditioning regimen for treatment of patients with relapsed or high-risk acute lymphoblastic leukemia who undergo allogeneic hematopoietic stem cell transplantation. Fifteen patients received fludarabine 30 mg/m(2), cytarabine 2000 mg/m(2), amsacrine 100 mg/m(2) on days -10, -9, -8 and -7, anti-thymocyte globulin (ATG-Fresenius) 20 mg/kg body weight on days -6, -5 and -4 and fractionated total body irradiation 2 x 2 Gy on days -3, -2 and -1 (FLAMSA-ATG-TBI) before allogeneic hematopoietic stem cell transplantation. At the time of hematopoietic stem cell transplantation, 10 patients were in complete remission (8 CR1; 2 CR2), 3 with primary refractory and 2 suffered from refractory relapse. All patients achieved a complete remission after hematopoietic stem cell transplantation; and after a median follow-up time of 1091 days (range, 334-1554 days), nine patients (60%) are alive and free from disease, including three patients with prior refractory disease. Three patients died due to treatment-related mortality. The most frequent and severe conditioning-related toxicities observed in 9 out of 15 patients were grade III/IV infections according to common toxicity criteria. Thus, conditioning with the FLAMSA-ATG-TBI regimen is a feasible and effective alternative for patients with relapsed or high-risk acute lymphoblastic leukemia.

Authors+Show Affiliations

Department of Haematology, Oncology and Clinical Immunology, Heinrich Heine-University, Düsseldorf, Germany. Fabian.Zohren@med.uni-duesseldorf.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Multicenter Study

Language

eng

PubMed ID

19430496

Citation

Zohren, F, et al. "Fludarabine, Amsacrine, High-dose Cytarabine and 12 Gy Total Body Irradiation Followed By Allogeneic Hematopoietic Stem Cell Transplantation Is Effective in Patients With Relapsed or High-risk Acute Lymphoblastic Leukemia." Bone Marrow Transplantation, vol. 44, no. 12, 2009, pp. 785-92.
Zohren F, Czibere A, Bruns I, et al. Fludarabine, amsacrine, high-dose cytarabine and 12 Gy total body irradiation followed by allogeneic hematopoietic stem cell transplantation is effective in patients with relapsed or high-risk acute lymphoblastic leukemia. Bone Marrow Transplant. 2009;44(12):785-92.
Zohren, F., Czibere, A., Bruns, I., Fenk, R., Schroeder, T., Gräf, T., Haas, R., & Kobbe, G. (2009). Fludarabine, amsacrine, high-dose cytarabine and 12 Gy total body irradiation followed by allogeneic hematopoietic stem cell transplantation is effective in patients with relapsed or high-risk acute lymphoblastic leukemia. Bone Marrow Transplantation, 44(12), 785-92. https://doi.org/10.1038/bmt.2009.83
Zohren F, et al. Fludarabine, Amsacrine, High-dose Cytarabine and 12 Gy Total Body Irradiation Followed By Allogeneic Hematopoietic Stem Cell Transplantation Is Effective in Patients With Relapsed or High-risk Acute Lymphoblastic Leukemia. Bone Marrow Transplant. 2009;44(12):785-92. PubMed PMID: 19430496.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fludarabine, amsacrine, high-dose cytarabine and 12 Gy total body irradiation followed by allogeneic hematopoietic stem cell transplantation is effective in patients with relapsed or high-risk acute lymphoblastic leukemia. AU - Zohren,F, AU - Czibere,A, AU - Bruns,I, AU - Fenk,R, AU - Schroeder,T, AU - Gräf,T, AU - Haas,R, AU - Kobbe,G, Y1 - 2009/05/11/ PY - 2009/5/12/entrez PY - 2009/5/12/pubmed PY - 2010/3/3/medline SP - 785 EP - 92 JF - Bone marrow transplantation JO - Bone Marrow Transplant VL - 44 IS - 12 N2 - In this prospective study, we examined the toxicity and efficacy of an intensified conditioning regimen for treatment of patients with relapsed or high-risk acute lymphoblastic leukemia who undergo allogeneic hematopoietic stem cell transplantation. Fifteen patients received fludarabine 30 mg/m(2), cytarabine 2000 mg/m(2), amsacrine 100 mg/m(2) on days -10, -9, -8 and -7, anti-thymocyte globulin (ATG-Fresenius) 20 mg/kg body weight on days -6, -5 and -4 and fractionated total body irradiation 2 x 2 Gy on days -3, -2 and -1 (FLAMSA-ATG-TBI) before allogeneic hematopoietic stem cell transplantation. At the time of hematopoietic stem cell transplantation, 10 patients were in complete remission (8 CR1; 2 CR2), 3 with primary refractory and 2 suffered from refractory relapse. All patients achieved a complete remission after hematopoietic stem cell transplantation; and after a median follow-up time of 1091 days (range, 334-1554 days), nine patients (60%) are alive and free from disease, including three patients with prior refractory disease. Three patients died due to treatment-related mortality. The most frequent and severe conditioning-related toxicities observed in 9 out of 15 patients were grade III/IV infections according to common toxicity criteria. Thus, conditioning with the FLAMSA-ATG-TBI regimen is a feasible and effective alternative for patients with relapsed or high-risk acute lymphoblastic leukemia. SN - 1476-5365 UR - https://www.unboundmedicine.com/medline/citation/19430496/Fludarabine_amsacrine_high_dose_cytarabine_and_12_Gy_total_body_irradiation_followed_by_allogeneic_hematopoietic_stem_cell_transplantation_is_effective_in_patients_with_relapsed_or_high_risk_acute_lymphoblastic_leukemia_ L2 - https://doi.org/10.1038/bmt.2009.83 DB - PRIME DP - Unbound Medicine ER -