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. 2012:1:54.
doi: 10.4103/2277-9175.100166. Epub 2012 Aug 28.

The mortality and response rate after FLANG regimen in patients with refractory/relapsed acute leukemia

Vali A Mehrzad  1 , Lida Liaghat, Farzaneh Ashrafi, Mehdi Tazhibi, Mehri Hajalikhani, Neda Alijanian
Affiliations

The mortality and response rate after FLANG regimen in patients with refractory/relapsed acute leukemia

Vali A Mehrzad et al. Adv Biomed Res. 2012.

Abstract

Background: Oncologists today are greatly concerned about the treatment of relapsed/refractory acute leukemia. FLANG regimen, combination of novantron, cytarabine, fludarabine, and granulocyte-colony stimulating factor, has been used in treatment of refractory/relapsed acute leukemia since 1990s. The present study has evaluated mortality and response rate of this regimen.

Materials and methods: In this study, 25 patients with refractory/relapsed acute leukemia aged 15-55 years underwent FLANG regimen at Seyed-Al-Shohada Hospital, Isfahan, Iran during 2008-2009. One month later, bone marrow samples were taken to evaluate the responsiveness to treatment. Participants were followed for a year. The data was analyzed by student-t and chi-square tests, logistic, and Cox regression analysis, and Kaplan-Meier curves in SPSS(19).

Results: Out of the 25 patients, 8 patients (32%) had acute lymphoblastic leukemia (5 refractory and 3 relapsed cases) and 17 subjects had acute myeloid leukemia (7 refractory and 10 relapsed cases). According to the bone marrow biopsies taken one month after FLANG regimen, 10 patients (40%) had responded to treatment. Five patients of the 10 responders underwent successful bone marrow transplantation (BMT). On the other hand, 13 patients (52%), who had not entered the CR period, died during the follow-up. Logistic regression analysis did not reveal any significant associations between disease type and responsiveness to treatment.

Conclusion: This study indicated higher rates of unresponsiveness to treatment while its mortality rate was comparable with other studies. Overall, according to limitations for BMT (as the only chance for cure) in Iran, it seems that FLANG therapy is an acceptable choice for these patients.

Keywords: Bone marrow transplantation; FLANG regimen; Refractory acute leukemia; Relapsed acute leukemia.

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Conflict of interest statement

Conflict of Interest: None declared

Figures

Figure 1
Figure 1
Kaplan-Meier curves of survival in 4 groups of leukemia in studied subjects
Figure 2
Figure 2
Kaplan-Meier curves of overall survival in studied subjects
See this image and copyright information in PMC

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