Tenold Matthew E, Moskoff Benjamin N, Krishnan Rajeev, Rosenberg Aaron S, Hoeg Rasmus T, Abedi Mehrdad, Tuscano Joseph M, Jonas Brian A
Division of Hematology and Oncology, Department of Internal Medicine, University of California Davis School of Medicine, Sacramento, CA.
Pharmacy Department, University of California Davis School of Medicine, Sacramento, CA.
Clin Lymphoma Myeloma Leuk. 2021 Jul;21(7):e611-e618. doi: 10.1016/j.clml.2021.02.007. Epub 2021 Mar 2.
FLAG ± Ida (fludarabine, cytarabine, granulocyte colony-stimulating factor, and idarubicin), is a salvage chemotherapy regimen for relapsed or refractory (R/R) acute myeloid leukemia (AML), with complete remission (CR) rates historically ranging from 52% to 63%. We review the outcomes for patients with R/R AML treated with FLAG ± Ida at the University of California Davis Comprehensive Cancer Center.
Adult patients (≥ 18 years) with R/R AML who received FLAG or FLAG + Ida from January 1, 2012 to October 31, 2016 were identified via chart review. Outcomes evaluated were CR, CR with incomplete hematologic recovery (CRi), overall response rate, overall survival (OS), relapse-free survival, and adverse events.
Forty-two patients were included. The median age was 52 years (range, 23-73 years), and 57% were male. Sixteen (38.1%) patients had relapsed disease, and 26 (61.9%) had refractory disease. Most (n = 35; 83.3%) patients had European LeukemiaNet intermediate-risk AML. Responses were CR in 20 (47.6%) and CRi in 6 (14.3%). The median OS was 10 months (range, 0.8-51 months), and the median relapse-free survival was 12 months (range, 1-51 months) for responders. The median OS for patients who achieved CR was not reached, and the estimated 48-month survival rate was 56%. The median OS after CRi or no response was 3.47 and 2.17 months, respectively. The median OS was not significantly different when censored for stem cell transplant following chemotherapy, nor with use/deferral of idarubicin. The most common adverse effects were pancytopenia and infection.
Patient outcomes after treatment with FLAG ± Ida for R/R AML remain similar to prior reports, confirming its role as a salvage regimen for these patients.
FLAG ± 伊达比星（氟达拉滨、阿糖胞苷、粒细胞集落刺激因子和伊达比星）是一种用于复发或难治性（R/R）急性髓系白血病（AML）的挽救性化疗方案，历史上完全缓解（CR）率为52%至63%。我们回顾了加利福尼亚大学戴维斯分校综合癌症中心接受FLAG ± 伊达比星治疗的R/R AML患者的治疗结果。
通过病历审查确定了2012年1月1日至2016年10月31日期间接受FLAG或FLAG + 伊达比星治疗的成年（≥18岁）R/R AML患者。评估的结果包括CR、血液学未完全恢复的CR（CRi）、总缓解率、总生存期（OS）、无复发生存期和不良事件。
纳入42例患者。中位年龄为52岁（范围23 - 73岁），57%为男性。16例（38.1%）患者为复发疾病，26例（61.9%）为难治性疾病。大多数（n = 35；83.3%）患者为欧洲白血病网中危AML。20例（47.6%）患者达到CR，6例（14.3%）达到CRi。应答者的中位OS为10个月（范围0.8 - 51个月），中位无复发生存期为12个月（范围1 - 51个月）。达到CR的患者的中位OS未达到，估计48个月生存率为56%。CRi或无反应后的中位OS分别为3.47个月和2.17个月。化疗后进行干细胞移植时，中位OS无显著差异，使用/推迟伊达比星时也无显著差异。最常见的不良反应是全血细胞减少和感染。
FLAG ± 伊达比星治疗R/R AML后的患者结果与先前报告相似，证实了其作为这些患者挽救方案的作用。
