Premium
FLAG (fludarabine + cytosine arabinoside + G‐CSF) induces complete remission in acute‐phase chronic myeloid leukaemia: a case report
Author(s) -
Visani G.,
Tosi P.,
Zinzani P. L.,
Manfroi S.,
Zaccaria A.,
Testoni N.,
Lemoli R. M.,
Rosti G.,
Pelliconi S.,
Tura S.
Publication year - 1994
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/j.1365-2141.1994.tb04749.x
Subject(s) - fludarabine , medicine , aclarubicin , granulocyte colony stimulating factor , cytarabine , bone marrow , myeloid , flag (linear algebra) , antimetabolite , regimen , gastroenterology , immunology , chemotherapy , cyclophosphamide , mathematics , pure mathematics , algebra over a field
Summary The adenine nucleoside analogue fludarabine phosphate in combination with cytosine‐arabinoside (Ara‐C) and granulocyte‐colony stimulating factor (G‐CSF) has recently proved effective in the treatment of poor‐prognosis acute non‐lymphoid leukaemia. We used this triple combination in a case of Ph1 + chronic myeloid leukaemia (CML) unresponsive to alpha interferon that had progressed to acute phase after 5 months of treatment with 6‐mercaptopurine plus hydroxyurea. The patient was treated with four courses of fludarabine 30 mg/m 2 + Ara‐C 2 g/m 2 (days 1–5) and GCSF (from day 0 to polymorphonuclear (PMN) recovery). Bone marrow blasts decreased from 80% to less than 5%, and karyotyping showed a progressive clearance of Ph1 + metaphases (from 100% to 9% after the fourth course). The patient is presently receiving autologous bone marrow transplantation (ABMT). This therapeutic success in a patient for whom conventional treatment would usually be ineffective makes this combination worthy of further studies, in view of its wider use as a preparative regimen to ABMT in CML.