PMID- 9003155
OWN - NLM
STAT- MEDLINE
DCOM- 19970211
LR  - 20220321
IS  - 0939-5555 (Print)
IS  - 0939-5555 (Linking)
VI  - 73
IP  - 6
DP  - 1996 Dec
TI  - FLAG (fludarabine, cytosine arabinoside, G-CSF) for refractory and relapsed acute 
      myeloid leukemia.
PG  - 265-71
AB  - Twenty-two patients with refractory or relapsed AML were treated with FLAG [25 
      mg/m2 fludarabine daily (days 1-5), 2 g/m2 daily Ara-C (days 1-5) and 400 
      micrograms/m2 daily G-CSF (day -1 till the absolute neutrophil count was > 
      500/microliter)]. Median age was 46 years (range 24-63). Eight patients had 
      leukemia which was primarily refractory to conventional regimens, six were in 
      first, seven were in second, and one was in third relapse. Overall, 11 of 22 
      (50%) patients achieved complete remission (CR), three had a partial response 
      (PR), and seven did not respond (NR). One patient died of an early cerebral 
      hemorrhage. The median remission duration from achievement of CR after FLAG was 
      9.9 months and median survival was 13.0 months. One patient is alive in CR at 
      31.9 months. Hematological toxicity of the regimen was severe. The median time to 
      neutrophil recovery (ANC > 500/microliter) was 21 days (range 18-33). A median of 
      seven red cell units (range 0-22) and of six platelet concentrate units (range 
      3-28) had to be given. Median duration of febrile neutropenia was 2 days (range 
      0-20 days) and patients were on i.v. antibiotics for a median of 16 days (range 
      0-51). There was no death from infection. Nonhematological toxicity was 
      remarkably low, with almost no neurotoxicity and no major hepatotoxicity. In 
      conclusion, FLAG seems to be an efficient and well tolerated regimen. It may be 
      particularly useful for patients who have a sibling or unrelated donor for 
      subsequent allogeneic bone marrow transplantation.
FAU - Huhmann, I M
AU  - Huhmann IM
AD  - First Department of Internal Medicine, University of Vienna, Austria.
FAU - Watzke, H H
AU  - Watzke HH
FAU - Geissler, K
AU  - Geissler K
FAU - Gisslinger, H
AU  - Gisslinger H
FAU - Jager, U
AU  - Jager U
FAU - Knobl, P
AU  - Knobl P
FAU - Pabinger, I
AU  - Pabinger I
FAU - Korninger, L
AU  - Korninger L
FAU - Mannhalter, C
AU  - Mannhalter C
FAU - Mitterbauer, G
AU  - Mitterbauer G
FAU - Schwarzinger, I
AU  - Schwarzinger I
FAU - Kalhs, P
AU  - Kalhs P
FAU - Haas, O A
AU  - Haas OA
FAU - Lechner, K
AU  - Lechner K
LA  - eng
PT  - Journal Article
PL  - Germany
TA  - Ann Hematol
JT  - Annals of hematology
JID - 9107334
RN  - 04079A1RDZ (Cytarabine)
RN  - 143011-72-7 (Granulocyte Colony-Stimulating Factor)
RN  - FA2DM6879K (Vidarabine)
RN  - FLAG protocol
SB  - IM
MH  - Acute Disease
MH  - Adult
MH  - Antineoplastic Combined Chemotherapy Protocols/*therapeutic use
MH  - Bone Marrow Transplantation/adverse effects
MH  - Central Nervous System Diseases/chemically induced
MH  - Cytarabine/therapeutic use/toxicity
MH  - Female
MH  - Granulocyte Colony-Stimulating Factor/therapeutic use/toxicity
MH  - Humans
MH  - Leukemia, Myeloid/*drug therapy/therapy
MH  - Male
MH  - Middle Aged
MH  - Nausea/chemically induced
MH  - Neutropenia/etiology
MH  - Treatment Outcome
MH  - Vidarabine/analogs & derivatives/therapeutic use/toxicity
MH  - Vomiting/chemically induced
EDAT- 1996/12/01 00:00
MHDA- 1996/12/01 00:01
CRDT- 1996/12/01 00:00
PHST- 1996/12/01 00:00 [pubmed]
PHST- 1996/12/01 00:01 [medline]
PHST- 1996/12/01 00:00 [entrez]
AID - 10.1007/s002770050239 [doi]
PST - ppublish
SO  - Ann Hematol. 1996 Dec;73(6):265-71. doi: 10.1007/s002770050239.