Effectiveness of FLAG chemotherapy in refractory or relapsed acute myeloid leukaemia

Abstract

The aim of this study was to analyse the feasibility of FLAG chemotherapy followed by allogeneic or autologous transplantation in refractory or relapsed acute myeloid leukemia (AML) prospectively. A total of 23 courses of FLAG was administered to 14 patients (8 refractory, 6 late relapse). Five of the 14 patients died of refractory disease during the first FLAG chemotherapy. Nine patients (64%) went into complete remission (CR) and received a consolidation course, but 5 of these patients died due to relapse (2) and sepsis (3) including an autologous transplant patient. Two of the 4 patients who remained alive proceeded to allogeneic peripheral blood stem cell transplantion and remained in CR at 34 and 40 months of follow-up respectively. FLAG chemotherapy was well tolerated with an acceptable toxicity. In conclusion, FLAG is an effective regimen with a satisfactory complete remission rate for patients with refractory or relapsed AML, but remissions are short-lasting unless consolidated with an allogeneic transplant which gives the chance of a prolonged survival and a potential cure.