Clinical experience of low-fludarabine, cytarabine, and G-CSF (FLAG regime) for refractory and relapsed acute leukemia

Objective To investigate the therapeutic effects, time of hematopoietic depression and side effects of low-fludarabine, cytarabine, and G-CSF (FLAG regime) for refractory and relapsed acute leukemia. Methods From July 2001 to Dec. 2003, 14 cases with refractory and relapsed acute leukemia were treated with fludarabine 50 mg/d (5～6 d), Ara-C 0.5～2.0 g/d (5～6 d), and G-CSF 300 μg/d (when the number of white blood cell exceed 10~9/L). Results The total response rate of 14 cases of refractory and relapsed acute leukemia was 28.5%, whereas the CR rate was only 14.3%. Neutropenia begin at the time of 5～9 days after the low-FLAG regimen initiating and last 7～30 days, thrombocytopenia begin at 5～10 days and last 6～30 days. The infection rate was 100%, serious infection was 37.5%, 2 cases died for early related therapy. Conclusion The low-FLAG shows poor effects for refractory and relapsed acute leukemia, and with serious hematopoietic depression.