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
European journal of haematology
2016Feb ; 96 ( 2 ) :188-97.
PMID : 25891993
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Kim, Hawk - Division of Hematology and Cellular Therapy, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
Lee, Je-Hwan - Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Ulsan, Korea.
Joo, Young-Don - Department of Hematology/Oncology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.
Bae, Sung Hwa - Department of Hematology-Oncology, Daegu Catholic University Medical Center, Catholic University of Daegu School of Medicine, Daegu, Korea.
Lee, Jung-Hee - Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Ulsan, Korea.
Kim, Dae-Young - Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Ulsan, Korea.
Lee, Won-Sik - Department of Hematology/Oncology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.
Ryoo, Hun-Mo - Department of Hematology-Oncology, Daegu Catholic University Medical Center, Catholic University of Daegu School of Medicine, Daegu, Korea.
Jo, Jae-Cheol - Division of Hematology and Cellular Therapy, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
Choi, Yunsuk - Division of Hematology and Cellular Therapy, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
Lee, Kyoo-Hyung - Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Ulsan, Korea. CN - CoOperative Study Group A for Hematology (COSAH)
ABSTRACT
Relapsed or refractory acute myeloid leukemia (R/R AML) in elderly (??0?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. CI - ??2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
keyword
FLAG; acute myeloid leukemia; continuous infusion; elderly; relapsed/refractory
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