Tek Merkez Deneyimi: Relaps / Refrakter Akut Lösemi ve Lenfoblastik Lenfomalı Olgularda Ida-FLAG Kemoterapisi,
Abstract
Keywords
References
- O’Donnell MR, Appelbaum FR, BaerMRet al. Acute myeloid leukemia clinical practice guidelines in oncology. J Natl Compr Canc Netw 2006;4:16–36.
- Kell J. Treatment of relapsed acute myeloid leukaemia. Rev Recent Clin Trials 2006;1: 103-111.
- Breems DA, Wim LJ, Huijgens PG, et al. Prognostic index for adult patients with acute myeloid leukemia in first relapse. Journal of Clinical Oncology 2005;23:1969- 1978.
- Specchia D, Pastore P, Carluccio A, et al. Liso FLAG- IDA in the treatment of refractory/relapsed adult acute lymphoblastic leukemia. Ann Hematol 2005;84: 792–795.
- de la Rubai J, Regadera I A, Mart´ın G, et al. FLAG- IDA regimen (fludarabine, cytarabine, idarubicin and G- CSF) in the treatment of patients with high-risk myeloid malignancies. Leukemia Research 2002; 725–730.
- Yavuz S, Paydas S, Disel U, Sahin B, Am J Ther. IDA- FLAG regimen for the therapy of primary refractory and relapse acute leukemia: a single-center experience. Am J Ther, 2006;13:389-393.
- Steinmetz HT, Schulz A, Staib P, et al. Phase-II trial of idarubicin, fludarabine, cytosine arabinoside, and filgrastim (Ida-FLAG) for treatment of refractory, relap- sed, and secondary AML. Ann Hematol 1999;78:418–425.
- Damaraju EV, Damaraju S, Young DJ, et al. Nucleoside anticancer drugs: the role of nucleoside transporters in resistance to cancer chemotherapy Oncogene 2003;22: 7524–7536.
- Gandhi V, Estey E, Keating M, Plunkett W. Fludarabine potentiates metabolism of cytarabine in patients with acute myelogenous leukemia during therapy. J Clin Oncol 1993;11:116–124.
- Michelutti A, Michieli M, Damiani D, et al. Effect of fludarabine and arabinosylcytosine on multidrugre- sistance cells. Haematologica 1997;82:143–147.
- Saydam G, Yüksel Ş, şahin F, Omay SB, Büyükkeçeci F. Refrakter-relapsli hematolojik maligniteli olgularda ida- flag kemoterapisi. Thod 2002;12; 22-27.
- Jackson GH, Taylor P, Smith GM, et al. A multicentre, open non comparative phase II study of a combination of fludarabine phosphate, cytarabine and granülocyte colony-stimulating factor in relapsed and refractory acute myeloid leukemia and de novo refractory anemia with excess of blast in transformation. B J Haematol 2001;112:127-137.
- Yalman N. Sarper N, Devecioğlu O, et al. Flag-IDA for the treatment of relapsed or poor risk childhood acute leukemia. T J Pediatr. 2000;42:198-204.
- Fleishhack G, Hasan C, Graf N, et al. IDA-FLAG, an effective remission induction theraphy for poor prognosis AML of childhood prior to allogeneic or autologous bone- marrow transpalantation: experience of phase II trial. Br J Haematol 1998;102:647-655.
- Pastore D, Specchia G, Carluccio P, et al. FLAG-IDA in the treatment of refractory/relapsed acute myeloid 17. Bow EJ, Laverdière M, Lussier N, Rotstein C, Cheang leukemia: single-center experience. Ann Hematol 2003; 82:231-235.
- Rotstein C, Bow EJ, Laverdie´re M, Ioannou S, Carr D, Moghaddam N. Randomized placebo-controlled trial of fluconazole prophylaxis for neutropenic cancer patients: benefit based upon purpose and intensity of cytotoxic therapy. Clin Infect Dis 1999;28:331–340.
- MS, Ioannou S. Antifungal prophylaxis for severely
- neutropenic chemotherapy recipients: a meta analysis of
- randomized-controlled clinical trials. Cancer. 2002 Jun 15;94:3230-3246.
Tek Merkez Deneyimi: Relaps / Refrakter Akut Lösemi ve Lenfoblastik Lenfomalı Olgularda Ida-FLAG Kemoterapisi
Abstract
Amaç: Primer refrakter ve/veya relaps akut lösemi olgularının yönetimi son derece zor olup sınırlı sayıda tedavi seçenekleri vardır ve bu hastalarda tam remisyon oranı düşük ve remisyon süreleri çok kısadır. İda-FLAG rejimi erişkin relaps, refrakter ve sekonder Akut Myeloblastik Lösemi, yüksek riskli Myelodisplastik Sendrom ve relaps/refrakter Akut Lenfoblastik Lösemi olgularında yaygın olarak kullanılmakta ve bu hastalarda ikincil remisyon için iyi bir seçenek olarak kabul edilmektedir. Gereç ve yöntem: Bu yazıda, merkezimizde İda-FLAG kemoterapisi uygulanan, yaş ortalaması 43,5 olan 13 relaps ve/veya refrakter akut lösemi ve 1 B hücreli lenfoblastik lenfomalı 14 hastanın sonuçları retrospektif olarak değerlendirilmiştir. Bulgular: Hastalardan 11’i ex olmuş (%78,6) 3 hastada (%21,4) ise komplet remisyon sağlanmıştır. Hastaların mortalite nedenleri incelendiğinde; 7 hasta sepsis, 2 hasta hastalık progresyonu, 1 hasta kanama ve 1 hastada Tip I solunum yetmezliği nedeni ile ex olmuştur. Bizim çalışmamızda en sık yan etki enfeksiyon olup, 10 hastada (%71) Grade III-IV olmak üzere hastaların tümünde enfeksiyon gelişmiştir. Sonuç: Bizim sonuçlarımız literatür verileri ile karşılaştırıldığında hastalarımızda komplet remisyon oranı düşük, toksisite profili ise daha yüksek olarak bulunmuştur. Bu sonuçlarla Relaps/Refrakter Akut Lösemi olgularında ikincil remisyon indüksiyonu amacı ile kullanılan İda-FLAG rejiminin iyi bir seçenek olmadığı düşünülmüştür
Keywords
References
- O’Donnell MR, Appelbaum FR, BaerMRet al. Acute myeloid leukemia clinical practice guidelines in oncology. J Natl Compr Canc Netw 2006;4:16–36.
- Kell J. Treatment of relapsed acute myeloid leukaemia. Rev Recent Clin Trials 2006;1: 103-111.
- Breems DA, Wim LJ, Huijgens PG, et al. Prognostic index for adult patients with acute myeloid leukemia in first relapse. Journal of Clinical Oncology 2005;23:1969- 1978.
- Specchia D, Pastore P, Carluccio A, et al. Liso FLAG- IDA in the treatment of refractory/relapsed adult acute lymphoblastic leukemia. Ann Hematol 2005;84: 792–795.
- de la Rubai J, Regadera I A, Mart´ın G, et al. FLAG- IDA regimen (fludarabine, cytarabine, idarubicin and G- CSF) in the treatment of patients with high-risk myeloid malignancies. Leukemia Research 2002; 725–730.
- Yavuz S, Paydas S, Disel U, Sahin B, Am J Ther. IDA- FLAG regimen for the therapy of primary refractory and relapse acute leukemia: a single-center experience. Am J Ther, 2006;13:389-393.
- Steinmetz HT, Schulz A, Staib P, et al. Phase-II trial of idarubicin, fludarabine, cytosine arabinoside, and filgrastim (Ida-FLAG) for treatment of refractory, relap- sed, and secondary AML. Ann Hematol 1999;78:418–425.
- Damaraju EV, Damaraju S, Young DJ, et al. Nucleoside anticancer drugs: the role of nucleoside transporters in resistance to cancer chemotherapy Oncogene 2003;22: 7524–7536.
- Gandhi V, Estey E, Keating M, Plunkett W. Fludarabine potentiates metabolism of cytarabine in patients with acute myelogenous leukemia during therapy. J Clin Oncol 1993;11:116–124.
- Michelutti A, Michieli M, Damiani D, et al. Effect of fludarabine and arabinosylcytosine on multidrugre- sistance cells. Haematologica 1997;82:143–147.
- Saydam G, Yüksel Ş, şahin F, Omay SB, Büyükkeçeci F. Refrakter-relapsli hematolojik maligniteli olgularda ida- flag kemoterapisi. Thod 2002;12; 22-27.
- Jackson GH, Taylor P, Smith GM, et al. A multicentre, open non comparative phase II study of a combination of fludarabine phosphate, cytarabine and granülocyte colony-stimulating factor in relapsed and refractory acute myeloid leukemia and de novo refractory anemia with excess of blast in transformation. B J Haematol 2001;112:127-137.
- Yalman N. Sarper N, Devecioğlu O, et al. Flag-IDA for the treatment of relapsed or poor risk childhood acute leukemia. T J Pediatr. 2000;42:198-204.
- Fleishhack G, Hasan C, Graf N, et al. IDA-FLAG, an effective remission induction theraphy for poor prognosis AML of childhood prior to allogeneic or autologous bone- marrow transpalantation: experience of phase II trial. Br J Haematol 1998;102:647-655.
- Pastore D, Specchia G, Carluccio P, et al. FLAG-IDA in the treatment of refractory/relapsed acute myeloid 17. Bow EJ, Laverdière M, Lussier N, Rotstein C, Cheang leukemia: single-center experience. Ann Hematol 2003; 82:231-235.
- Rotstein C, Bow EJ, Laverdie´re M, Ioannou S, Carr D, Moghaddam N. Randomized placebo-controlled trial of fluconazole prophylaxis for neutropenic cancer patients: benefit based upon purpose and intensity of cytotoxic therapy. Clin Infect Dis 1999;28:331–340.
- MS, Ioannou S. Antifungal prophylaxis for severely
- neutropenic chemotherapy recipients: a meta analysis of
- randomized-controlled clinical trials. Cancer. 2002 Jun 15;94:3230-3246.
There are 19 citations in total.
Details
| Primary Language | Turkish |
|---|---|
| Journal Section | Articles |
| Authors | |
| Publication Date | August 1, 2011 |
| Submission Date | August 11, 2015 |
| Published in Issue | Year 2011 Volume: 25 Issue: 2 |