FLAG salvage therapy combined with idarubicin in relapsed/refractory acute myeloid leukemia

Abstract

Acute myeloid leukemia (AML) is characterized by a high failure rate to achieve complete remission as well as high relapse rates that cause an emergent need for efficient and tolerable salvage therapies. The combination of FLAG with idarubicin (FLAG-Ida) is a widely used protocol. However, its efficacy has been analyzed in only a limited number of studies with majorly small patient cohorts. Here, we analyzed 132 patients with largely primary refractory or first-time relapsed AML treated according to the FLAG-Ida protocol. The overall complete remission rate (CR + CRi) was 56% with a median overall survival of 15 months (95% CI, 5.7–25.1). The median disease-free survival for CR/CRi-patients was not reached. The mortality rate on day 30 was 9% and increased on day 60 to 16%. Our results show in relapsed/refractory AML patients a high efficacy and compatibility for the FLAG-Ida regimen.

Keywords:

• Acute myeloid leukemia
• salvage therapy
• anthracycline
• FLAG-Ida

Acknowledgments

The authors would like to thank Nils Lehmann, institute of medical informatics, biometry and epidemiology, University Hospital Essen, University Duisburg-Essen for consultation on statistical analyses.

Potential conflict of interest

Disclosure forms provided by the authors are available with the full text of this article online at https://doi.org/108010428194.2018.1508670.