IDA-FLAG Regimen for the Therapy of Primary Refractory and Relapse Acute Leukemia: A Single-Center Experience
IDA-FLAG Regimen for the Therapy of Primary Refractory and Relapse Acute Leukemia: A Single-Center Experience
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IDA-FLAG 治疗原发性难治性和复发性急性白血病的方案：单中心经验
DOI：
10.1097/01.mjt.0000181690.21601.09
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发表时间：
2006
影响因子：
4.2
通讯作者：
B. Şahin
中科院分区：
文献类型：
--
作者：
S. Yavuz;S. Paydaş;U. Disel;B. Şahin
我们评估了氟达拉滨、Ara-C、伊达比星和 G-CSF (Ida-FLAG) 联合化疗对 56 名难治性和/或复发性急性白血病患者的疗效和毒性。患者接受磷酸氟达拉滨 25 mg/m2/d (d1-5)、Ara-C 2 g/m2/d (d1-5)、伊达比星 12 mg/m2/d (d1-3) 治疗，从第六天起皮下注射 G-CSF，直至绝对中性粒细胞计数 (ANC) >500/μL。三分之一的急性髓细胞白血病 (AML) 和 45% 的急性淋巴细胞白血病 (ALL) 病例是原发性难治性疾病。在 AML 患者中，15 例（53.6%）达到完全缓解（CR）。 1例显示部分缓解（PR）（3.6%），12例（42.8%）对此方案耐药（RD）。所有 AML 病例均出现 IV 级血液毒性。白细胞恢复时间为16天。非血液系统并发症为轻度至中度恶心、呕吐和粘膜炎，可通过常规措施控制。 5例患者进行干细胞移植，全部获得CR，其中2例自体干细胞移植，3例异体干细胞移植。 22例ALL患者中，CR和PR分别为8例（42.2%）和2例（10.5%）； 9 例 (47.3%) 病例对 Ida-FLAG 具有耐药性。所有病例均出现 IV 级血液毒性。白细胞恢复时间为17天。非血液学毒性包括恶心、呕吐和粘膜炎，可以通过支持治疗来控制。 1例患者接受自体移植，但5周后疾病复发。缓解率与白血病亚型（AML 与 ALL）、白细胞计数、年龄、性别、疾病状态（新发与继发）和 RFS（早期复发与晚期复发）之间没有相关性（P > 0.05）。所有病例的中位生存期均为 16 周（AML 为 22 周，而 AML 为 13 周）。目前，仅有3名患者存活，其中2名患者处于持续缓解状态。其余患者均死亡。总之，Ida-FLAG 是难治性/复发性急性白血病挽救化疗的良好选择。高功效和低毒性是该方案的优选特性，并且已发现该方案可用于细胞减灭术，特别是对于异基因 SCT 候选者。
We evaluated efficacy and toxicity profiles of fludarabine, Ara-C, idarubicin, and G-CSF (Ida-FLAG) combination chemotherapy in 56 refractory and/or relapsed acute leukemia patients. Patients were treated with fludarabine phosphate 25 mg/m2/d (d1-5), Ara-C 2 g/m2/d (d1-5), idarubicin 12 mg/m2/d (d1-3), G-CSF was given subcutaneously from sixth day until absolute neutrophil count (ANC) >500/μL. One third of the acute myeloblastic leukemia (AML) and 45% of acute lymphoblastic leukemia (ALL) cases were primary refractory disease. In AML patients, complete remission (CR) was achieved in 15 cases (53.6%). One case showed partial remission (PR) (3.6%) and 12 cases (42.8%) had resistant to this regimen (RD). Grade IV hematologic toxicity occurred in all AML cases. Leukocyte recovery time was 16 days. Nonhematologic complications were mild to moderate nausea, vomiting, and mucositis and could be controlled by routine measures. Stem cell transplantation was performed in 5 patients and all achieved CR, 2 autologous and 3 allogeneic. In ALL patients, CR and PR were obtained in 8 (42.2%) and 2 (10.5%) of 22 cases; disease was resistant to Ida-FLAG in 9 (47.3%) cases. Grade IV hematologic toxicity occurred in all ALL cases. Leukocyte recovery time was 17 days. Nonhematologic toxicity consisted of nausea, vomiting, and mucositis and could be controlled by supportive therapy. Autologous transplantation was performed in 1 patient, but relapse disease occurred after 5 weeks. There was no correlation between response rate and leukemia subtype (AML versus ALL), leukocyte count, age, sex, disease status (de novo versus secondary), and RFS (early versus late relapse) (P > 0.05). Median survival was 16 weeks in all cases (22 weeks in AML versus 13 weeks). At present, only 3 patients are alive and 2 of these are in continuous remission. The rest of the patients died. In conclusion, Ida-FLAG is a good choice in cases with refractory/relapsing acute leukemia for salvage chemotherapy. High efficacy and a low-toxicity profile are preferable properties of this regimen, and this regimen has been found to be useful for cytoreduction, especially in candidates for allo-SCT.
影响因子：
45.3
作者：
GANDHI, V;ESTEY, E;PLUNKETT, W
通讯作者：
PLUNKETT, W