Treatment of "poor risk" acute myeloid leukemia with Fludarabine, Cytarabine and G-CSF (Flag regimen): A single center study

A. M. Carella, N. Cascavilla, M. M. Greco, L. Melillo, M. R. Sajeva, S. Ladogana, G. D'Arena, G. Perla, M. Carotenuto

Research output: Contribution to journalArticle


We describe a single center experience of 41 consecutive patients with poor prognosis acute myeloid leukemia (AML) who received a single course of FLAG regimen consisting of Fludarabine 30 mg/m 2/day plus Cytarabine 2 gr/ m 2/day (days 1-5) and G-CSF 5 mg/Kg/day (from day 0 to polymorphonuclear recovery) as salvage therapy. Eleven patients were primarily refractory to previous chemotherapy, 10 patients were in first relapse, 2 patients in second relapse and 7 patients in relapse after transplants. Eleven cases were defined as secondary AML (diagnosis of AML made after a preexisting diagnosis of myelodysplastic syndrome). The median age was 52.6 years (range 16-72); 29 patients were males and 12 females. Overall, 23 (56%) patients reached complete remission (CR), 3 patients died of infection (2) or hemorrhage (1) during induction, and 15 (36%) patients had resistant disease. The highest CR rates (80%) were obtained in relapsed cases; de novo and secondary AML registered 60% and 45% of CR rates, respectively. Patients achieving CR received a second FLAG course as consolidation and were submitted to an individualized program post-remission therapy, depending on the age and performance status. Hematological and non hematological toxicities were acceptable. In conclusion, our data confirm that FLAG is a an high effective treatment for poor prognosis AML and in young patients allows intensive post remissional therapy including allogeneic BMT.

Original languageEnglish
Pages (from-to)295-303
Number of pages9
JournalLeukemia and Lymphoma
Issue number3-4
Publication statusPublished - 2001



  • Acute myeloid leukemia
  • Chemotherapy
  • FLAG regimen
  • Poor risk

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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