| Autor: |
Nösslinger, T, Koller, E., Tüchler, H., Jadrna, K., Bernhart, M., Pittermann, E., Pfeilstöcker, M. |
| Předmět: |
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| Zdroj: |
Acta Medica Austriaca; Jul2001 Supplement 54, Vol. 28, p8-8, 1/3p |
| Abstrakt: |
Background: The objectives of this analysis were to evaluate the efficacy and toxicity profiles of the combination of fludarabine and high-dose cytosine arabinoside (Ara-C) in refractory or relapsed high risk hematological malignancies. Methods: Thirty-six patients (28 AML, 5 ALL, 3 NHL) were treated with a total of 60 cycles of FLAG (30 mg/m² fludarabine days 1-5, 2 g/m² Ara-C days 1-5 and 5 mg/kg G-CSF day 0 to polymorph-nuclear recovery, in 5 cycles 10 mg/m² idarubicine days 1-3 was added). The median age was 50 years (range 18-65) and the sex ratio was 1:1. Before administration of FLAG the patients had received in median live cycles of conventional chemotherapy (range 1-12): five patients (14%) were refractory to these regimens, twenty-four (67%) were in first and seven (19%) were in second or subsequent relapse, with a median response duration of twenty months to reduction therapy. Results: Eleven patients (31%) achieved a complete (CR) and six (17%) a partial remission (PR). twelve patients (33%) had resistant disease and seven (19%) died during remission induction, four due to progressive disease and three due to pneumonia. The median CR duration was 8.5 months and the median survival duration was 4 months for all patients and 10 months for those who had response to treatment. Eleven patients (31%) are still alive with six of them in continous CR. Hematological toxicity was quite severe, more pronounced in patients receiving additional idarubicine. Median time to neutrophil (>1,000/µl) and to platelet 1>20,000/µl) recovery were 22 days (ranges 14-31 and 13-36 respectively). A median of 6 red cell units (range 0-25) and of 7 platelet concentrates (range 2-28) had to be given. Median duration of febrile neutropenia was 5 days (range 0-35) and i.v. antibitoics were administered in all patients for a median of 19 days (range 8-50). There were 49 documented infections with 29 septical events and 20 pneumonias. Nonhematological toxicity was low. The median period of hospitalization was 29 days (range 17-60). Conclusions: FLAG is an efficient regimen with tolerable toxicitiy in relapsed AML. Subsequent courses are recommended. if CR or PR is achieved after the first cycle. Addition of idarubicine seems to lead to increased side effects, without improving the remission rate. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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