Fludarabine, ARA-C, idarubicin and G-CSF (FLAG-Ida), high dose ARA-C and early stem cell transplant. A feasable and effective therapeutic strategy for De Novo AML patients

M. Clavio, S. Gatto, G. Beltrami, S. Quintino, L. Canepa, I. Pierri, V. Galbusera, P. Carrara, M. Miglino, R. Varaldo, F. Ballerini, C. Venturino, R. Cerri, M. Risso, E. Balleari, A. M. Carella, M. Sessarego, R. Ghio, A. Bacigalupo, Marco Gobbi

Research output: Contribution to journalArticle

Abstract

Forty-three consecutive patients with de novo and untreated non M3 AML aged 60 or less entered the study. The mean age of patients was 50 (range 15-60). The induction regimen (FLAG-Ida) included fludarabine (30 mg/sqm), Ara-C (2 g/sqm) on days 1-5, and idarubicin (10 mg/sqm) on days 1,3,5. G-CSF (300 mcg / day) was administered s.c. 12 hours before starting fludarabine and was continued for five days. HDT with stem cell rescue was planned for all patients in first CR after one course of high dose Ara-C (HDAC) consolidation and in good clinical conditions. Forty-two (98%) patients were evaluable for response. One patient died during induction (2%). CR was achieved in 35 patients (82%). Twenty-three patients, 66% of those achieving CR, underwent autologous (N = 17) or allogeneic (N = 6) transplantation. With a median follow up of 24 months, the average median duration of CR is 17 months (range 3-66) and the median survival is 20 months (range 1-83). Overall the 5 year projected disease free survival (DFS) and overall survival (OS) were 37% and 43%, respectively. Among patients who underwent stem cell transplantation DFS and OS were 53% and 69%, respectively. The median time to PMN recovery (> 0.5 × 109 / 1) was 17 days (range 10-28) and 50 × 109 / 1 platelets were reached at a median of 17 days (12-38). In conclusion FLAG-Ida regimen is effective, low toxic and improves feasibility of stem cell transplant.

Original languageEnglish
Pages (from-to)481-487
Number of pages7
JournalJournal of Experimental and Clinical Cancer Research
Volume21
Issue number4
Publication statusPublished - Dec 2002

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Keywords

  • Allogeneic bone marrow transplantation
  • Autologous peripheral blood progenitor cell transplantation
  • FLAG-Ida
  • Fludarabine
  • Stem cells mobilization

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Clavio, M., Gatto, S., Beltrami, G., Quintino, S., Canepa, L., Pierri, I., Galbusera, V., Carrara, P., Miglino, M., Varaldo, R., Ballerini, F., Venturino, C., Cerri, R., Risso, M., Balleari, E., Carella, A. M., Sessarego, M., Ghio, R., Bacigalupo, A., & Gobbi, M. (2002). Fludarabine, ARA-C, idarubicin and G-CSF (FLAG-Ida), high dose ARA-C and early stem cell transplant. A feasable and effective therapeutic strategy for De Novo AML patients. Journal of Experimental and Clinical Cancer Research, 21(4), 481-487.