1.The Clinical Outcome of FLAG Chemotherapy without Idarubicin in Patients with Relapsed or Refractory Acute Myeloid Leukemia.
Se Ryeon LEE ; Deok Hwan YANG ; Jae Sook AHN ; Yeo Kyeoung KIM ; Je Jung LEE ; Young Jin CHOI ; Ho Jin SHIN ; Joo Seop CHUNG ; Yoon Young CHO ; Yee Soo CHAE ; Jong Gwang KIM ; Sang Kyun SOHN ; Hyeoung Joon KIM
Journal of Korean Medical Science 2009;24(3):498-503
A refractory and resistant disease to conventional induction chemotherapy and relapsed disease are considered as the most important adverse prognostic factors for acute myeloid leukemia (AML). Sixty-one patients (median age, 33.6 yr) with relapsed or refractory AML were treated with the FLAG regimen that consisted of fludarabine (30 mg/m2, days 1-5), cytarabine (2.0 g/m2, days 1-5) and granulocyte colony-stimulating factor. Of the treated patients 29 patients (47.5%) achieved complete remission (CR). Higher CR rates were observed for patients with a first or second relapse as compared to patients with a primary refractory response or relapse after stem cell transplantation (HSCT). There was a significant difference in the response rates according to the duration of leukemia-free survival (pre-LFS) before chemotherapy (P=0.05). The recovery time of both neutrophils (> or =500/microL) and platelets (> or =20,000/microL) required a median of 21 and 18 days, respectively. Treatment-related mortality (TRM) occurred in seven patients (11.4%), of which 71.4% of TRM was caused by an invasive aspergillosis infection. After achieving CR, 18 patients underwent consolidation chemotherapy and six patients underwent allogeneic HSCT. In conclusion, FLAG chemotherapy without idarubicin is a relatively effective and well-tolerated regimen for relapsed or refractory AML and the use of FLAG chemotherapy has allowed intensive post-remission therapy including HSCT.
Adult
;
Aged
;
Antineoplastic Combined Chemotherapy Protocols/*therapeutic use
;
Cytarabine/*therapeutic use/toxicity
;
Disease-Free Survival
;
Female
;
Granulocyte Colony-Stimulating Factor/*therapeutic use/toxicity
;
Humans
;
Idarubicin/therapeutic use
;
Leukemia, Myeloid, Acute/*drug therapy/mortality
;
Male
;
Middle Aged
;
Recurrence
;
Treatment Outcome
;
Vidarabine/*analogs & derivatives/therapeutic use/toxicity
2.The Clinical Outcome of FLAG Chemotherapy without Idarubicin in Patients with Relapsed or Refractory Acute Myeloid Leukemia.
Se Ryeon LEE ; Deok Hwan YANG ; Jae Sook AHN ; Yeo Kyeoung KIM ; Je Jung LEE ; Young Jin CHOI ; Ho Jin SHIN ; Joo Seop CHUNG ; Yoon Young CHO ; Yee Soo CHAE ; Jong Gwang KIM ; Sang Kyun SOHN ; Hyeoung Joon KIM
Journal of Korean Medical Science 2009;24(3):498-503
A refractory and resistant disease to conventional induction chemotherapy and relapsed disease are considered as the most important adverse prognostic factors for acute myeloid leukemia (AML). Sixty-one patients (median age, 33.6 yr) with relapsed or refractory AML were treated with the FLAG regimen that consisted of fludarabine (30 mg/m2, days 1-5), cytarabine (2.0 g/m2, days 1-5) and granulocyte colony-stimulating factor. Of the treated patients 29 patients (47.5%) achieved complete remission (CR). Higher CR rates were observed for patients with a first or second relapse as compared to patients with a primary refractory response or relapse after stem cell transplantation (HSCT). There was a significant difference in the response rates according to the duration of leukemia-free survival (pre-LFS) before chemotherapy (P=0.05). The recovery time of both neutrophils (> or =500/microL) and platelets (> or =20,000/microL) required a median of 21 and 18 days, respectively. Treatment-related mortality (TRM) occurred in seven patients (11.4%), of which 71.4% of TRM was caused by an invasive aspergillosis infection. After achieving CR, 18 patients underwent consolidation chemotherapy and six patients underwent allogeneic HSCT. In conclusion, FLAG chemotherapy without idarubicin is a relatively effective and well-tolerated regimen for relapsed or refractory AML and the use of FLAG chemotherapy has allowed intensive post-remission therapy including HSCT.
Adult
;
Aged
;
Antineoplastic Combined Chemotherapy Protocols/*therapeutic use
;
Cytarabine/*therapeutic use/toxicity
;
Disease-Free Survival
;
Female
;
Granulocyte Colony-Stimulating Factor/*therapeutic use/toxicity
;
Humans
;
Idarubicin/therapeutic use
;
Leukemia, Myeloid, Acute/*drug therapy/mortality
;
Male
;
Middle Aged
;
Recurrence
;
Treatment Outcome
;
Vidarabine/*analogs & derivatives/therapeutic use/toxicity
3.Granulocyte-colony stimulating factor decreases the extent of ovarian damage caused by cisplatin in an experimental rat model.
Ali AKDEMIR ; Burak ZEYBEK ; Levent AKMAN ; Ahment Mete ERGENOGLU ; Ahmet Ozgur YENIEL ; Oytun ERBAS ; Altug YAVASOGLU ; Mustafa Cosan TEREK ; Dilek TASKIRAN
Journal of Gynecologic Oncology 2014;25(4):328-333
OBJECTIVE: To investigate whether granulocyte-colony stimulating factor (G-CSF) can decrease the extent of ovarian follicle loss caused by cisplatin treatment. METHODS: Twenty-one adult female Sprague-Dawley rats were used. Fourteen rats were administered 2 mg/kg/day cisplatin by intraperitoneal injection twice per week for five weeks (total of 20 mg/kg). Half of the rats (n=7) were treated with 1 mL/kg/day physiological saline, and the other half (n=7) were treated with 100 microg/kg/day G-CSF. The remaining rats (n=7, control group) received no therapy. The animals were then euthanized, and both ovaries were obtained from all animals, fixed in 10% formalin, and stored at 4degrees C for paraffin sectioning. Blood samples were collected by cardiac puncture and stored at -30degrees C for hormone assays. RESULTS: All follicle counts (primordial, primary, secondary, and tertiary) and serum anti-Mullerian hormone levels were significantly increased in the cisplatin+G-CSF group compared to the cisplatin+physiological saline group. CONCLUSION: G-CSF was beneficial in decreasing the severity of follicle loss in an experimental rat model of cisplatin chemotherapy.
Animals
;
Anti-Mullerian Hormone/blood
;
Antineoplastic Agents/*toxicity
;
Biological Markers/blood
;
Cisplatin/*toxicity
;
Disease Models, Animal
;
Drug Evaluation, Preclinical/methods
;
Female
;
Fertility Preservation/methods
;
Granulocyte Colony-Stimulating Factor/*therapeutic use
;
Ovarian Follicle/drug effects/pathology
;
Primary Ovarian Insufficiency/blood/chemically induced/pathology/*prevention & control
;
Rats, Sprague-Dawley