Fludarabine, ARA-C, G-CSF with or without mitoxantrone (flang - plag) au tolerable and effective in bad prognosis acute mveloid leukemia patients

chari of henaology DIMI div enal;li 1, Agenda Oapedate S. Martine-, Geneva Pion May 1993 ta Febroary 1996 FLAG and FLANC schemes were employed is induction therapy of 46 hi|gh ante myenid kxaasia (AML) patients. In 20 patients Ihe diamls at AML was précédai by a syndrome tatted mare Ihe six moMhe; ft of thé 26 denovo AML wen refractory M previous chemotherapy lines . 8 Mere trratuil for eerty relapse , 10 hid peor yiutmBU bctan M rtinmnii. The medîMi a»e was 64 (luv 33-75); Ihe FAB »Hyp» were Ihe fcflowinf: MO 3. Ml 4 M2 25, M4 6, M5 8. FHly per cent of patkm had poor provnH ckranoimial abnormaKliei « «. FLAG (24 palientt) rn.simd of Flackrabine 30 iqAqm i> 30 nlrnK, followed, after 4 bom, by Au-C 2 ( / aqx in 4 homn (fcr 5 day) wd of OCSF 300 aiicrai / dk. FtANG (22palic HO) and plaulm (Pi > 20000) recover? rcqund a median of 17 and 21 dtyi from the end of itarapy The infcoi« oompllcalkM have been Bpeii (9), branoopsninnisa (9, four of whkk caaaad I Aapaiilhia) and FUO (14). Overall 26 patienta (97%) nachedCR, 7 (13%) PR, 10(22%)vererdracloryand3(6%)diedduring ireboion Tte(«pie«ertpo«lea«l« ranje« fh 2 to 24 momhi, with a median follow ap of 7 mottaa. De nom and secondary AML had 65 and 4]% CR rale. Seven out of 8 paderefr«loryBhoer2oiilofp « IreaKd for retapât (Mained CR (23%). Abnonnal karoli|je had a neaitive innmaonCR rme in secondary AML (30% compered to 75% in pntienu with normal cytofenetic analyali). Secondary AML patents over yean of ate bad a better outcome compared nilli ihr, mill r um Iff« mil 14% of CR). A poor oatoome in M4-M5 secondary AML pattenH has been observai FLAG and FLANG ahowed ssmilar activity and proved lo be uknMe and effective in hijh risk denovo AML and even in secondary leukemia.