FLAG-MIT Regimen in Treament of Patients with Refractory or Relasped Acute Leukemia

Objective To evaluate the efficacy and toxicity of the mitoxantrone combination with fludarabine,high-dose cytarabine(Ara-C) and granulocyte-colony-stimulating factor(G-CSF) in treatment of patients with refractory or relapsed acute leukemia(AL) patients.Methods 12 patients aged from 16 to 78 years with relapsed(n = 4) or refractory(n = 8) AL were treated with mitoxantrone(6-10 mg/d,days1 to 3),fludarabine(30 mg/m2·d,days 1 to 5),cytarabine(0.5-1.0 g/m2 ·d,days 1 to 5),granulocyte colony-stimulating factor(300 μg/d,from WBC 1.0 × 109 /L until absolute neutrophil count 0.5 × 109 /L).Results After one course of induction therapy,8 patients were acute myeloblastic leukemia(AML) and 1 patient was acute lymphoblastic(ALL) achieved completed remission(CR),1 patient was AML-M4 achieved partial(PR) remission,2 patients were ALL didn't achieved remission(NR),Myclosuppression and infections due to neutropenia were the most frequent adverse effects,gastrolntestinal side effects were moderate,predominantly reaching WHO grades 12.2 patients had myocardial damage and 1 patient had phlebitis and could be controlled by supportive therapy.No patient suffered an early death.Conclusion FLAG combined with mitoxantrone regimen has shown high efficacy in treatment of patients with refractory or relapsed AL,especially in AML,but this protocol has shown partial afficacy in ALL.The adverse effects from this regimen were well tolerated by patients.