The clinical outcome of FLAG chemotherapy without idarubicin in patients with relapsed or refractory acute myeloid leukemia

Se Ryeon Lee, Deok Hwan Yang, Jae Sook Ahn, Yeo Kyeoung Kim, Je Jung Lee, Young Jin Choi, Ho Jin Shin, Joo Seop Chung, Yoon Young Cho, Yee Soo Chae, Jong Gwang Kim, Sang Kyun Sohn, Hyeoung Joon Kim

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19 Citations (Scopus)

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 languageEnglish
Pages (from-to)498-503
Number of pages6
JournalJournal of Korean Medical Science
Volume24
Issue number3
DOIs
Publication statusPublished - 2009 Jun 1
Externally publishedYes

Keywords

  • Acute
  • FLAG Chemotherapy
  • Leukemia
  • Myeloid
  • Toxicity

ASJC Scopus subject areas

  • Medicine(all)

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  • Cite this

    Lee, S. R., Yang, D. H., Ahn, J. S., Kim, Y. K., Lee, J. J., Choi, Y. J., Shin, H. J., Chung, J. S., Cho, Y. Y., Chae, Y. S., Kim, J. G., Sohn, S. K., & Kim, H. J. (2009). The clinical outcome of FLAG chemotherapy without idarubicin in patients with relapsed or refractory acute myeloid leukemia. Journal of Korean Medical Science, 24(3), 498-503. https://doi.org/10.3346/jkms.2009.24.3.498