Fludarabine, High Dose Cytarabine and Granulocyte Colony-Stimulating Factor (FLAG) as Consolidation Chemotherapy in Older Patients with Acute Myeloid Leukemia: A Retrospective Cohort Study
Autor: | Kok Haur Ng, Nor Aishah Hamzah, Kian Boon Law, Tee Chuan Ong, Kian Meng Chang |
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Rok vydání: | 2017 |
Předmět: |
Oncology
medicine.medical_specialty endocrine system diseases business.industry Proportional hazards model Hazard ratio food and beverages Induction chemotherapy Consolidation Chemotherapy Hematology Surgery Fludarabine 03 medical and health sciences Regimen 0302 clinical medicine 030220 oncology & carcinogenesis Internal medicine medicine FLAG (chemotherapy) Original Article business Survival analysis 030215 immunology medicine.drug |
Zdroj: | Indian Journal of Hematology and Blood Transfusion. 33:483-491 |
ISSN: | 0974-0449 0971-4502 |
DOI: | 10.1007/s12288-017-0790-3 |
Popis: | The study aimed to investigate the effect of consolidation treatment with fludarabine, high-dose cytarabine and granulocyte colony-stimulating factor or FLAG in older AML patients. The study included 41 eligible patients above 54 years old, who received both induction and consolidation chemotherapy for AML from 2008 to 2013. The study cohort had a minimum 24 months follow-up period. Survival analysis was carried out to assess patients’ overall survival and disease free survival based on types of consolidation regimens. The consolidation treatment with FLAG exerted a protective effect to both overall survival and disease free survival in older patients. Patients who were consolidated with FLAG regimen had a significant longer overall survival (log-rank, p = 0.0025) and disease free survival (log-rank, p = 0.0026). The median overall survival was longer (18.70 months) with the use of FLAG when compared to non-FLAG group (8.09 months). The median disease free survival was also longer (13.84 months) with use of FLAG when compared to the non-FLAG group (4.44 months). Regression analysis with Cox model yielded hazard ratio of 0.245 (p = 0.0094) in overall survival and 0.217 (p = 0.0068) in disease free survival. The use of FLAG as consolidation treatment was associated with approximately 60–80% reduction in hazard rates. The result was adjusted for age, race and gender in regression analysis. Older AML patients had longer remission and survival when consolidated with FLAG regimen after the induction chemotherapy. |
Databáze: | OpenAIRE |
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