PMID: 9003155Dec 1, 1996Paper

FLAG (fludarabine, cytosine arabinoside, G-CSF) for refractory and relapsed acute myeloid leukemia

Annals of Hematology
I M HuhmannK Lechner

Abstract

Twenty-two patients with refractory or relapsed AML were treated with FLAG [25 mg/m2 fludarabine daily (days 1-5), 2 g/m2 daily Ara-C (days 1-5) and 400 micrograms/m2 daily G-CSF (day -1 till the absolute neutrophil count was > 500/microliter)]. Median age was 46 years (range 24-63). Eight patients had leukemia which was primarily refractory to conventional regimens, six were in first, seven were in second, and one was in third relapse. Overall, 11 of 22 (50%) patients achieved complete remission (CR), three had a partial response (PR), and seven did not respond (NR). One patient died of an early cerebral hemorrhage. The median remission duration from achievement of CR after FLAG was 9.9 months and median survival was 13.0 months. One patient is alive in CR at 31.9 months. Hematological toxicity of the regimen was severe. The median time to neutrophil recovery (ANC > 500/microliter) was 21 days (range 18-33). A median of seven red cell units (range 0-22) and of six platelet concentrate units (range 3-28) had to be given. Median duration of febrile neutropenia was 2 days (range 0-20 days) and patients were on i.v. antibiotics for a median of 16 days (range 0-51). There was no death from infection. Nonhematological toxicity was r...Continue Reading

Citations

Jan 5, 2002·Hematological Oncology·R J Frewin, S A Johnson
Jul 27, 2001·Mathematical Biosciences·E K Afenya
Oct 16, 1999·British Journal of Haematology·D K Webb
Sep 6, 2002·Seminars in Hematology·Richard M Stone
Mar 8, 2012·Journal of Pediatric Hematology/oncology·Paola QuarelloFranca Fagioli
Oct 26, 2013·Paediatric Drugs·Jennifer DavilaThomas Renaud
Apr 12, 2003·Leukemia & Lymphoma·Tadeusz Robak
Jan 30, 2010·Clinical Therapeutics·Tadeusz Robak, Agnieszka Wierzbowska
Jul 8, 2009·International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases·Ewa Lech-MarandaTadeusz Robak
Jun 13, 1998·American Journal of Hematology·M MontilloF Ferrara
Dec 12, 2018·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Adir ShaulovCamilla Zimmermann

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