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- Title
Treatment of core-binding-factor in acute myelogenous leukemia with fludarabine, cytarabine, and granulocyte colony-stimulating factor results in improved event-free survival.
- Authors
Borthakur, Gautam; Kantarjian, Hagop; Xuemei Wang; Plunkett Jr., William K.; Gandhi, Varsha V.; Faderl, Stetan; Garcia-Manero, Guillermo; Ravandi, Farhad; Pierce, Sherry; Estey, Elihu H.; Wang, Xuemei; Plunkett, William K Jr; Faderl, Stefan
- Abstract
<bold>Background: </bold>Acute myelogenous leukemia (AML) associated with core-binding-factor (CBF) abnormalities is the type of leukemia most responsive to cytarabine (ara-C) therapy and is of relative favorable prognosis. In vitro and ex vivo observations suggest that increases in intracellular ara-C levels influenced by administration of fludarabine and granulocyte colony-stimulating factor (GCSF) increase the effect of ara-C, prompting us to clinically evaluate the efficacy of such combinations.<bold>Methods: </bold>We analyzed the event-free survival of patients with newly diagnosed CBF AML treated with fludarabine and ara-C (FA) (N = 45) or with FA and GCSF (FLAG) (N = 22) and compared results to patients treated with regimens consisting of idarubicin and ara-C with or without GCSF (IA/IAG) (N = 47).<bold>Results: </bold>After accounting for prognostic covariates other than treatment (including year in which treatment was administered), FA, and in particular FLAG, were associated with longer event-free survival than IA/IAG.<bold>Conclusions: </bold>Thus, our data lends clinical credence to the observed modulation of ara-C by fludarabine and GCSF.
- Subjects
ACUTE myeloid leukemia; FLUDARABINE; CYTARABINE; GRANULOCYTES; COLONY-stimulating factors (Physiology); ANTINEOPLASTIC agents; PROTEIN metabolism; THERAPEUTIC use of antimetabolites; ANTIMETABOLITES; ANTIVIRAL agents; COMPARATIVE studies; RESEARCH methodology; GRANULOCYTE-colony stimulating factor; MEDICAL cooperation; MULTIVARIATE analysis; PROGNOSIS; RESEARCH; RESEARCH funding; EVALUATION research; IDARUBICIN; THERAPEUTICS
- Publication
Cancer (0008543X), 2008, Vol 113, Issue 11, p3181
- ISSN
0008-543X
- Publication type
journal article
- DOI
10.1002/cncr.23927