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Fludarabine, cytarabine, granulocyte colony-stimulating factor, and idarubicin (FLAG-IDA) for the treatment of children with poor-prognosis acute leukemia: the Hacettepe experience.
Pediatr Hematol Oncol. 2010 Oct; 27(7):517-28.PH

Abstract

Fludarabine, cytarabine, granulocyte colony-stimulating factor (G-CSF), and idarubicin (FLAG-IDA) regimen has been proven to be a potentially useful chemotherapy regimen for relapsed or poor-prognosis childhood leukemia. The aim of the study was to evaluate complete remission (CR) rate, toxicity, and overall survival of children with poor-prognosis acute leukemia who received the FLAG-IDA regimen. Furthermore, the authors investigated the children who achieved CR following FLAG-IDA treatment regarding their eligibility for allogeneic hematopoietic stem cell transplantation (HSCT). Between January 2002 and April 2007, 25 children with poor-prognosis acute leukemia were treated with FLAG-IDA regimen in our center. Of the 25 children (16 AML, 9 ALL) with poor-prognosis acute leukemia, 7 (28.0%) received 1 cycle, 17 (68.0%) received 2 cycles, and 1 (4%) received 3 cycles of FLAG or FLAG-IDA regimen. After 44 cycles of FLAG-IDA or FLAG regimen, 10/25 (40%) children were nonresponders, 15/25 (60.0%) showed CR. Five (20%) of these patients in CR who underwent allogeneic HSCT are still in remission. The remaining 20 (80.0%) children were lost due to infection or relapse of the primary diseases. The overall survival of patients who are still alive and underwent allogeneic HSCT (mean: 40.6 ± 4.7, median: 40, range: 34-46 months) was longer than that of patients (mean: 5.5 ± 4.3, median: 4, range: 1-15 months) who did not undergo allogeneic HSCT. The CR rate was quite high in the present study using the FLAG-IDA regimen, and the authors believe this regimen is a possible option prior to allogeneic HSCT in children with poor-prognosis acute leukemia.

Authors+Show Affiliations

Pediatric Hematology Unit, Ihsan Dogramacı Children's Hospital, Hacettepe University Faculty of Medicine, Ankara, Turkey.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20677923

Citation

Tavil, Betul, et al. "Fludarabine, Cytarabine, Granulocyte Colony-stimulating Factor, and Idarubicin (FLAG-IDA) for the Treatment of Children With Poor-prognosis Acute Leukemia: the Hacettepe Experience." Pediatric Hematology and Oncology, vol. 27, no. 7, 2010, pp. 517-28.
Tavil B, Aytac S, Balci YI, et al. Fludarabine, cytarabine, granulocyte colony-stimulating factor, and idarubicin (FLAG-IDA) for the treatment of children with poor-prognosis acute leukemia: the Hacettepe experience. Pediatr Hematol Oncol. 2010;27(7):517-28.
Tavil, B., Aytac, S., Balci, Y. I., Unal, S., Kuskonmaz, B., Yetgin, S., Gurgey, A., Tuncer, M., Gumruk, F., Uckan, D., & Cetin, M. (2010). Fludarabine, cytarabine, granulocyte colony-stimulating factor, and idarubicin (FLAG-IDA) for the treatment of children with poor-prognosis acute leukemia: the Hacettepe experience. Pediatric Hematology and Oncology, 27(7), 517-28. https://doi.org/10.3109/08880018.2010.493578
Tavil B, et al. Fludarabine, Cytarabine, Granulocyte Colony-stimulating Factor, and Idarubicin (FLAG-IDA) for the Treatment of Children With Poor-prognosis Acute Leukemia: the Hacettepe Experience. Pediatr Hematol Oncol. 2010;27(7):517-28. PubMed PMID: 20677923.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fludarabine, cytarabine, granulocyte colony-stimulating factor, and idarubicin (FLAG-IDA) for the treatment of children with poor-prognosis acute leukemia: the Hacettepe experience. AU - Tavil,Betul, AU - Aytac,Selin, AU - Balci,Yasemin Isik, AU - Unal,Sule, AU - Kuskonmaz,Barıs, AU - Yetgin,Sevgi, AU - Gurgey,Aytemiz, AU - Tuncer,Murat, AU - Gumruk,Fatma, AU - Uckan,Duygu, AU - Cetin,Mualla, PY - 2010/8/4/entrez PY - 2010/8/4/pubmed PY - 2011/2/12/medline SP - 517 EP - 28 JF - Pediatric hematology and oncology JO - Pediatr Hematol Oncol VL - 27 IS - 7 N2 - Fludarabine, cytarabine, granulocyte colony-stimulating factor (G-CSF), and idarubicin (FLAG-IDA) regimen has been proven to be a potentially useful chemotherapy regimen for relapsed or poor-prognosis childhood leukemia. The aim of the study was to evaluate complete remission (CR) rate, toxicity, and overall survival of children with poor-prognosis acute leukemia who received the FLAG-IDA regimen. Furthermore, the authors investigated the children who achieved CR following FLAG-IDA treatment regarding their eligibility for allogeneic hematopoietic stem cell transplantation (HSCT). Between January 2002 and April 2007, 25 children with poor-prognosis acute leukemia were treated with FLAG-IDA regimen in our center. Of the 25 children (16 AML, 9 ALL) with poor-prognosis acute leukemia, 7 (28.0%) received 1 cycle, 17 (68.0%) received 2 cycles, and 1 (4%) received 3 cycles of FLAG or FLAG-IDA regimen. After 44 cycles of FLAG-IDA or FLAG regimen, 10/25 (40%) children were nonresponders, 15/25 (60.0%) showed CR. Five (20%) of these patients in CR who underwent allogeneic HSCT are still in remission. The remaining 20 (80.0%) children were lost due to infection or relapse of the primary diseases. The overall survival of patients who are still alive and underwent allogeneic HSCT (mean: 40.6 ± 4.7, median: 40, range: 34-46 months) was longer than that of patients (mean: 5.5 ± 4.3, median: 4, range: 1-15 months) who did not undergo allogeneic HSCT. The CR rate was quite high in the present study using the FLAG-IDA regimen, and the authors believe this regimen is a possible option prior to allogeneic HSCT in children with poor-prognosis acute leukemia. SN - 1521-0669 UR - https://www.unboundmedicine.com/medline/citation/20677923/Fludarabine_cytarabine_granulocyte_colony_stimulating_factor_and_idarubicin__FLAG_IDA__for_the_treatment_of_children_with_poor_prognosis_acute_leukemia:_the_Hacettepe_experience_ L2 - https://www.tandfonline.com/doi/full/10.3109/08880018.2010.493578 DB - PRIME DP - Unbound Medicine ER -