The efficacy of Fludarabine, high dose cytosine arabinoside with granulocyte colony stimulating factor (FLAG) protocol as salvage therapy for Refractory/Relapsed Acute Leukemias in adult Iraqi patients.
Background and Objective: Refractory/relapsed acute leukemia has always been a challenging problem for hematologist. Over the past decade emphasis has been made in the development of regimens containing fludarabine, combined with cytosine arabinoside for the treatment of refractory/relapsed acute le...
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| Format: | Article |
| Language: | English |
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PAGEPress Publications
2014-08-01
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| Series: | Mediterranean Journal of Hematology and Infectious Diseases |
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| Online Access: | https://mjhid.org/index.php/mjhid/article/view/1734 |
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| author | Alaa Fadhil Alwan bassam F Matti Alaadin S Naji Ali muhammad J Almudaffar |
| author_facet | Alaa Fadhil Alwan bassam F Matti Alaadin S Naji Ali muhammad J Almudaffar |
| author_sort | Alaa Fadhil Alwan |
| collection | DOAJ |
| description | Background and Objective: Refractory/relapsed acute leukemia has always been a challenging problem for hematologist. Over the past decade emphasis has been made in the development of regimens containing fludarabine, combined with cytosine arabinoside for the treatment of refractory/relapsed acute leukemias. The aim of this study is to evaluate the efficacy and toxicity of the combination of fludarabine, high dose cytarabine, and granulocyte colony stimulating factor in refractory relapsed cases of acute leukaemia,
Patients and Methods: a prospective study is being conducted at the national center of hematology and hematology unit /Baghdad teaching hospital from July 2008 to July 2010.Twenty Patients with refractory/relapsed acute leukemia were treated with fludarabine 30mg/m2 and cytosine arabinoside (AraC) 2 g/m2 for 5 days, and granulocyte colony stimulating factor G-CSF 300 microgram/day from day 0 till neutrophil recovery (ANC >1.0 x 109/l).Response was evaluated by bone marrow examination on day 30-post chemotherapy.
Results: Patients included were refractory acute lymphoblastic leukemia (ALL) (n=5), relapsed ALL (n=4), refractory acute myeloid leukemia (AML) (n=8), relapsed AML (n=3). Complete remission (CR) was achieved in 9(45%) patients, 3 (15%) patients got partial remission. Three (15%) patients died of post chemotherapy complications and 5(25%) patient failed to achieve remission. Major complications encountered were: anemia, fever, bleeding, mucositis and bacterial infections.
Conclusion: FLAG protocol is well tolerated and effective regimen in relapsed / refractory acute leukemias. The toxicity is acceptable, enabling most patients to receive further treatment, including transplantation procedures
Key words: FLAG, refractory acute leukemia, relapsed acute leukemia |
| format | Article |
| id | doaj-art-d39ee5bf8bfb4a56805f205c7e46011c |
| institution | Kabale University |
| issn | 2035-3006 |
| language | English |
| publishDate | 2014-08-01 |
| publisher | PAGEPress Publications |
| record_format | Article |
| series | Mediterranean Journal of Hematology and Infectious Diseases |
| spelling | doaj-art-d39ee5bf8bfb4a56805f205c7e46011c2024-12-02T00:02:02ZengPAGEPress PublicationsMediterranean Journal of Hematology and Infectious Diseases2035-30062014-08-011The efficacy of Fludarabine, high dose cytosine arabinoside with granulocyte colony stimulating factor (FLAG) protocol as salvage therapy for Refractory/Relapsed Acute Leukemias in adult Iraqi patients.Alaa Fadhil Alwan0bassam F Matti1Alaadin S Naji2Ali muhammad J Almudaffar3the national center of hematologybaghdad teaching hospitalbaghdad teaching hospitalbaghdad teaching hospitalBackground and Objective: Refractory/relapsed acute leukemia has always been a challenging problem for hematologist. Over the past decade emphasis has been made in the development of regimens containing fludarabine, combined with cytosine arabinoside for the treatment of refractory/relapsed acute leukemias. The aim of this study is to evaluate the efficacy and toxicity of the combination of fludarabine, high dose cytarabine, and granulocyte colony stimulating factor in refractory relapsed cases of acute leukaemia, Patients and Methods: a prospective study is being conducted at the national center of hematology and hematology unit /Baghdad teaching hospital from July 2008 to July 2010.Twenty Patients with refractory/relapsed acute leukemia were treated with fludarabine 30mg/m2 and cytosine arabinoside (AraC) 2 g/m2 for 5 days, and granulocyte colony stimulating factor G-CSF 300 microgram/day from day 0 till neutrophil recovery (ANC >1.0 x 109/l).Response was evaluated by bone marrow examination on day 30-post chemotherapy. Results: Patients included were refractory acute lymphoblastic leukemia (ALL) (n=5), relapsed ALL (n=4), refractory acute myeloid leukemia (AML) (n=8), relapsed AML (n=3). Complete remission (CR) was achieved in 9(45%) patients, 3 (15%) patients got partial remission. Three (15%) patients died of post chemotherapy complications and 5(25%) patient failed to achieve remission. Major complications encountered were: anemia, fever, bleeding, mucositis and bacterial infections. Conclusion: FLAG protocol is well tolerated and effective regimen in relapsed / refractory acute leukemias. The toxicity is acceptable, enabling most patients to receive further treatment, including transplantation procedures Key words: FLAG, refractory acute leukemia, relapsed acute leukemiahttps://mjhid.org/index.php/mjhid/article/view/1734FLAGrefractory acute leukemiarelapsed acute leukemia |
| spellingShingle | Alaa Fadhil Alwan bassam F Matti Alaadin S Naji Ali muhammad J Almudaffar The efficacy of Fludarabine, high dose cytosine arabinoside with granulocyte colony stimulating factor (FLAG) protocol as salvage therapy for Refractory/Relapsed Acute Leukemias in adult Iraqi patients. Mediterranean Journal of Hematology and Infectious Diseases FLAG refractory acute leukemia relapsed acute leukemia |
| title | The efficacy of Fludarabine, high dose cytosine arabinoside with granulocyte colony stimulating factor (FLAG) protocol as salvage therapy for Refractory/Relapsed Acute Leukemias in adult Iraqi patients. |
| title_full | The efficacy of Fludarabine, high dose cytosine arabinoside with granulocyte colony stimulating factor (FLAG) protocol as salvage therapy for Refractory/Relapsed Acute Leukemias in adult Iraqi patients. |
| title_fullStr | The efficacy of Fludarabine, high dose cytosine arabinoside with granulocyte colony stimulating factor (FLAG) protocol as salvage therapy for Refractory/Relapsed Acute Leukemias in adult Iraqi patients. |
| title_full_unstemmed | The efficacy of Fludarabine, high dose cytosine arabinoside with granulocyte colony stimulating factor (FLAG) protocol as salvage therapy for Refractory/Relapsed Acute Leukemias in adult Iraqi patients. |
| title_short | The efficacy of Fludarabine, high dose cytosine arabinoside with granulocyte colony stimulating factor (FLAG) protocol as salvage therapy for Refractory/Relapsed Acute Leukemias in adult Iraqi patients. |
| title_sort | efficacy of fludarabine high dose cytosine arabinoside with granulocyte colony stimulating factor flag protocol as salvage therapy for refractory relapsed acute leukemias in adult iraqi patients |
| topic | FLAG refractory acute leukemia relapsed acute leukemia |
| url | https://mjhid.org/index.php/mjhid/article/view/1734 |
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