FLAG regimen in the treatment of refractory/relapsed acute leukemia

Objective To evaluate the efficacy and toxicity of the combination of fludarabine(Flud), cytosine arabinoside (Ara-C),and granulocyte colony-stimulating factor (G-CSF)(FLAG) in refractory/relapsed acute leukemia (AL) patients.Methods 12 patients were treated with FLAG regimen (relapsed ALL,seven; relapsed AML,one;refractory AML,tow;CML-blast phase,tow).Results 5 patients (42 %) and 1 patient achieved complete remission (CR) and partial remission (PR),respectively,and all of the responders were the patients with relapsed ALL.GradeⅣhematologic toxicity occurred in all chemotherapeutic courses.Neu- tropenic fever was seen in 74 % of courses,bleeding 48 %.There was a 17 % incidence of treatment-related deaths.Nonhematological side effects,consisting mainly of nausea/vomiting,diarrhea,conjunciva congest,rash or flush skin,liver toxicity and drug fever,were generally tolerated.Conclusion Hematologic toxicity of FLAG regimen is sever,the other mild.It is effective regimen in relapsed/refractory AL,enabling patients to receive further transplantation procedures.