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/m2, days 1-5), cytarabine (2.0 g/m2, 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/μL) and platelets (≥20,000/μL) 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.
| Original language | English |
|---|---|
| Pages (from-to) | 498-503 |
| Number of pages | 6 |
| Journal | Journal of Korean Medical Science |
| Volume | 24 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - 2009 Jun 1 |
| Externally published | Yes |
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Keywords
- Acute
- FLAG Chemotherapy
- Leukemia
- Myeloid
- Toxicity
ASJC Scopus subject areas
- Medicine(all)
Cite this
The clinical outcome of FLAG chemotherapy without idarubicin in patients with relapsed or refractory acute myeloid leukemia. / Lee, Se Ryeon; Yang, Deok Hwan; Ahn, Jae Sook; Kim, Yeo Kyeoung; Lee, Je Jung; Choi, Young Jin; Shin, Ho Jin; Chung, Joo Seop; Cho, Yoon Young; Chae, Yee Soo; Kim, Jong Gwang; Sohn, Sang Kyun; Kim, Hyeoung Joon.
In: Journal of Korean Medical Science, Vol. 24, No. 3, 01.06.2009, p. 498-503.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - The clinical outcome of FLAG chemotherapy without idarubicin in patients with relapsed or refractory acute myeloid leukemia
AU - Lee, Se Ryeon
AU - Yang, Deok Hwan
AU - Ahn, Jae Sook
AU - Kim, Yeo Kyeoung
AU - Lee, Je Jung
AU - Choi, Young Jin
AU - Shin, Ho Jin
AU - Chung, Joo Seop
AU - Cho, Yoon Young
AU - Chae, Yee Soo
AU - Kim, Jong Gwang
AU - Sohn, Sang Kyun
AU - Kim, Hyeoung Joon
PY - 2009/6/1
Y1 - 2009/6/1
N2 - 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/m2, days 1-5), cytarabine (2.0 g/m2, 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/μL) and platelets (≥20,000/μL) 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.
AB - 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/m2, days 1-5), cytarabine (2.0 g/m2, 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/μL) and platelets (≥20,000/μL) 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.
KW - Acute
KW - FLAG Chemotherapy
KW - Leukemia
KW - Myeloid
KW - Toxicity
UR - http://www.scopus.com/inward/record.url?scp=67649158524&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=67649158524&partnerID=8YFLogxK
U2 - 10.3346/jkms.2009.24.3.498
DO - 10.3346/jkms.2009.24.3.498
M3 - Article
C2 - 19543516
AN - SCOPUS:67649158524
VL - 24
SP - 498
EP - 503
JO - Journal of Korean Medical Science
JF - Journal of Korean Medical Science
SN - 1011-8934
IS - 3
ER -