Mito-FLAG regimen for refractory or relapsed acute myeloid leukemia

Objective:To observe the therapeutic effects and side effects of Mito-FLAG regimen (mitoxantrone, fludarabine, Ara-C, and granulocyte-colony stimulating factor (G-CSF) for refractory or relapsed acute myeloid leukemia (AML).Methods: The regimen consisted of Mito 10 mg/d on d1 (one patient received 15 mg/d on d1, and another one received 5 mg/d, from d1 to d5); Flu 30 mg·m-2·d-1 i.v. 30 min, from d1 to d 5; Ara-C 1.5 g·m-2·d-1 i.v. 4 h, from d1 to d5, and G-CSF 30 μg·kg-1·d-1 from d0 until the WBC 20×109/L. Nine cases (total 11 times) of refractory or relapsed acute myeloid leukemia were treated with this regimen. Results:In the 9 cases of leukemia the complete remission rate was 44.4% (4/9), and for the 7 cases of refractory AML, complete remission rate was 57%. The overall responsible rate was 66.7% (6/9). Three cases had no response and among them one case died at early period.The main toxicities were myelosupression, gastrointestinal side effects, slight jaundice, and phlebitis. Conclusion:Mito-FLAG shows favorable outcome for refractory and relapsed acute leukemia, and can be employed for the patients with refractory or relapsed AML who had no response to the first line regimen or other salvage regimens. It will get a chance for further hematopoietic stem cell transplantation.