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- Title
A prospective, multicenter phase II study of continuous infusion of FLAG for patients older than 60 yr with resistant acute myeloid leukemia: a comparison with intensive younger patients' trial.
- Authors
Kim, Hawk; Lee, Je‐Hwan; Joo, Young‐Don; Bae, Sung Hwa; Lee, Jung‐Hee; Kim, Dae‐Young; Lee, Won‐Sik; Ryoo, Hun‐Mo; Jo, Jae‐Cheol; Choi, Yunsuk; Lee, Kyoo‐Hyung
- Abstract
Relapsed or refractory acute myeloid leukemia (R/R AML) in elderly (≥60 yr old) patients were eligible. Induction chemotherapy consisted fludarabine and cytarabine ( ARAC) as a 24-hr CI without idarubicin (C- FLAG), which was compared with the results of C- FLAG with idarubicin ( CI- FLAG2) in younger patients' trial. A total of 33 and 68 patients were enrolled in C- FLAG and CI- FLAG2, respectively. CR, CRp, and CRi were achieved in 10 (30.3%), 3 (9.1%), and 2 (6.1%), respectively. When comparing outcomes between C- FLAG and CI- FLAG2, there were no difference in terms of CR rate ( P = 0.572) and objective response rate ( ORR; P = 0.899). Favorable predictors on ORR in C- FLAG were PB WBC ≤ 20K/ uL at salvage ( P = 0.024) and early evaluation peripheral BLAST = 0% ( P = 0.013) on multivariate analysis. The overall survival of patients who achieve CR/ CRp/ CRi showed significantly prolonged survival compared with patients who did not in C- FLAG ( P < 0.001) and was a favorable predictor of longer survival by multivariate analysis ( P = 0.009). Median overall survival was 3.19 (95% CI, 2.05-4.33) months and similar with that of CI- FLAG2 ( P = 0.841). Attenuated salvage regimen C- FLGA in elderly patients was as effective as more intensive younger patients' regimen CI- FLAG2 in terms of response and survival although elderly patients had more unfavorable clinical characteristics.
- Subjects
ACUTE myeloid leukemia; CYTARABINE; FLUDARABINE; IDARUBICIN; CANCER chemotherapy
- Publication
European Journal of Haematology, 2016, Vol 96, Issue 2, p188
- ISSN
0902-4441
- Publication type
Article
- DOI
10.1111/ejh.12568