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• W162698082 abstract "A number of cytogenetic patterns have been identified as being disadvantageous for response to treatment in AML. In addition, the presence of an antecedent hematologic disorder (AHD) also consistently has a negative impact on prognosis being closely related with the incidence of myelodysplasia. Since 1991, the MDACC has elected to treat patients (pts) with adverse cytogenetics and/or an AHD (AML, poor risk) with a combination of regimens based on the synergism between the fludarabine (Fludara) and cytosine arabinoside (ara-C). Fludara enhances the ara-CTP formation in leukemic blast cells. Thus, a combination regimen of Fludara and ara-C (FA) was developed in 1991. Subsequently, GCSF was added being given before, during, and after the FA to form the FLAG regimen. In more recent times, idarubicin has been added. Thus, the FLAG-Ida regimen is Fludara 30 mg/m2/day for 5 days followed each day 4 hours later by ara-C 2 g/m2 over 4 h. GCSF at a dose of 200 µg/m2 is given 1 day before and during the therapy. Use following completion of chemotherapy is according to need of the patient. Idarubicin is given at a dose of 12 mg/m2/day for 3 days. Pts treated with prior regimens in 1980–1990 had a complete remission rate of 38%. The combined results of the FA, FLAG, and FLAG-Ida regimens is 66 CRs of 131 pts (50%). The CR rate to FA was 12/30 (40%), FLAG 27/49 (55%), and FLAG-Ida 27/52 (52%). There was no increase in the mortality during remission induction caused by the addition of idarubicin. Comparison to the historical past of patients treated between 1986–1990 demonstrates an advantage in CR rate which is not statistically significant for the FA, FLAG, and FLAG-Ida regimens. The CR duration at 2 and 3 years, however, is substantially higher with these regimens than previous experience. A multivariate analysis for response and survival will be carried out on this patient population to identify risk factors. Age, poor performance status, hypoalbuminemia, and treatment outside a protected environment all appear to be adverse at this time." @default.
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• W162698082 date "1998-01-01" @default.
• W162698082 modified "2023-10-12" @default.
• W162698082 title "FLAG-Ida, an Effective Regimen for High Risk AML" @default.
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• W162698082 doi "https://doi.org/10.1007/978-3-642-71960-8_112" @default.
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