Comparison of clinical remission and survival between CLAG and FLAG induction chemotherapy in patients with refractory or relapsed acute myeloid leukemia: a prospective cohort study

• Y. Bao ^[1] ; J. Zhao ^[2] ; Z.-Z. Li ^[1]
  1. [1] Hubei University of Medicine

     Hubei University of Medicine

     China

     
  2. [2] Huazhong University of Science and Technology

     Huazhong University of Science and Technology

     China

     
• Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 20, Nº. 7 (July 2018), 2018, págs. 870-880
• Idioma: inglés
• Texto completo no disponible (Saber más ...)
• Resumen

  • Purpose To compare the clinical remission and survival between CLAG and FLAG induction chemotherapy in treating patients with refractory or relapsed acute myeloid leukemia (R/R AML).

    Methods 103 R/R AML patients were consecutively enrolled in this prospective cohort study. 55 patients were treated by CLAG induction chemotherapy as follows: 5 mg/m2/day cladribine (days 1–5); 2 g/m2/day cytarabine (days 1–5) and 300 μg/day filgrastim (days 0–5). While 48 patients were treated by FLAG: 30 mg/m2/day fludarabine (days 1–5), 2 g/m2/day cytarabine (days 1–5), and 300 μg/day filgrastim (days 0–5).

    Results CLAG induction chemotherapy achieved 61.7% complete remission rate (CR) and 78.7% overall remission rate (ORR), which was similar with FLAG chemotherapy which realized 48.7% CR and 69.2% ORR. No difference of overall survival (OS) was discovered between two groups either. Age cytarabine 60 years, secondary disease, poor risk stratification and BM blast ≥ 42.7% and second or higher salvage therapy were independent factors for worse prognosis. Subgroups analysis revealed that in patients with second or higher salvage therapy, CLAG seemed to achieve a higher CR than FLAG. And in patients with relapsed disease, poor risk stratification or CR at first induction, CLAG seemed to realize a prolonged OS compared to FLAG.

    Conclusion CLAG was equally effective to FLAG induction chemotherapy in total R/R AML patients, while CLAG seemed to be a better option than FLAG in patients with relapsed disease, poor risk stratification, CR at first induction or second or higher salvage therapies.