FLAG (fludarabine + cytosine arabinoside + G-CSF) induces complete remission in acute-phase chronic myeloid leukaemia: A case report

G. Visani, P. Tosi, P. L. Zinzani, S. Manfroi, A. Zaccaria, N. Testoni, R. M. Lemoli, G. Rosti, S. Pelliconi, S. Tura

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Abstract

The adenine nucleoside analogue fludarabine phosphate in combination with cytosine-arabinoside (Ara-C) and granulocyte-colony stimulating factor (G- CSF) has recently proved effective in the treatment of poor-prognosis acute non-lymphoid leukaemia. We used this triple combination in a case of Ph1 + chronic myeloid leukaemia (CML) unresponsive to alpha interferon that had progressed to acute phase after 5 months of treatment with 6-mercaptopurine plus hydroxyurea. The patient was treated with four courses of fludarabine 30 mg/m2 + Ara-C 2 g/m2 (days 1-5) and G-CSF (from day O to polymorphonuclear (PMN) recovery). Bone marrow blasts decreased from 80% to less than 5%, and karyotyping showed a progressive clearance of Ph1+ metaphases (from 100% to 9% after the fourth course). The patient is presently receiving autologous bone marrow transplantation (ABMT). This therapeutic success in a patient for whom conventional treatment would usually be ineffective makes this combination worthy of further studies, in view of its wider use as a preparative regimen to ABMT in CML.

Original languageEnglish
Pages (from-to)394-396
Number of pages3
JournalBritish Journal of Haematology
Volume86
Issue number2
Publication statusPublished - 1994

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Keywords

  • chronic myeloid leukaemia
  • cytosine arabinoside
  • fludarabine
  • nucleosides
  • therapy

ASJC Scopus subject areas

  • Hematology

Cite this

Visani, G., Tosi, P., Zinzani, P. L., Manfroi, S., Zaccaria, A., Testoni, N., Lemoli, R. M., Rosti, G., Pelliconi, S., & Tura, S. (1994). FLAG (fludarabine + cytosine arabinoside + G-CSF) induces complete remission in acute-phase chronic myeloid leukaemia: A case report. British Journal of Haematology, 86(2), 394-396.