Early allogeneic transplantation for refractory or relapsed acute leukaemia following remission induction with FLAG

Leukemia
J L ByrneNigel Russell

Abstract

The prognosis for patients with secondary AML, primary resistant AML or ALL and early (<12 months) relapse of acute leukaemia remains extremely poor with conventional chemotherapy. As part of a strategy to improve the outcome for these patients we have treated 22 consecutive patients (18 AML, four ALL, median age 35 years) with either primary resistant disease (n=3), early relapsed leukaemia (n= 12) or secondary AML (n= 7, four RAEBt, two antecedant ALL and one antecedant Hodgkin's disease) with 'FLAG' induction chemotherapy with the aim of proceeding to early allogeneic transplantation either from sibling or unrelated donors. Eighteen patients achieved CR after one course of FLAG, including five patients who had documented p-glycoprotein-induced multidrug resistance and 10 patients with adverse cytogenetic abnormalities. Eight patients were consolidated with a second course of FLAG prior to transplantation and so far 16 patients have undergone allogeneic transplantation, 10 from unrelated donors and six from sibling donors (one mismatched). By the time of transplant three patients had progressed and were in early relapse and all have relapsed post BMT. Of the remaining 13 patients transplanted in remission, nine remain in CCR ...Continue Reading

Citations

Mar 7, 2006·Nature Reviews. Drug Discovery·Gergely SzakácsMichael M Gottesman
May 3, 2000·Journal of Hematotherapy & Stem Cell Research
May 30, 2001·Leukemia & Lymphoma·G LeoneL Pagano
Dec 6, 2011·Farmacia hospitalaria : órgano oficial de expresión científica de la Sociedad Española de Farmacia Hospitalaria·L Domínguez SenínE Martín Chacón
Mar 21, 2006·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Asha JohnyThomas J Nevill
Apr 12, 2003·Leukemia & Lymphoma·Tadeusz Robak
Jan 11, 2008·American Journal of Physiology. Regulatory, Integrative and Comparative Physiology·J JoynerK B Brosnihan
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