FLAG-Dauno vs FLAG-Ida: Bursa Uludağ University Experience in Relaps/Refractory Acute Leukemia Cases

Öz

FLAG-Ida protocol (Fludarabine- Cytarabine- Granulocyte Colony Stimulating Factor- Idarubicin) is a chemotherapy regimen frequently used in relapsed/refractory acute leukemia cases. Daunorubicin can be used instead of idarubicin as an anthracycline agent, especially due to problems in drug access. In our study, we aimed to evaluate the efficacy and side effect data of patients with relapsed/refractory acute leukemia who received FLAG-Ida or FLAG-Dauno protocol in the haematology clinic of Bursa Uludag University. A total of 94 patients were included in the study. Ten patients were in the FLAG-Dauno group and 84 patients were in the FLAG-Ida group. The median age of the study group was 46.5 years. Acute Myeloid Leukemia (AML) was diagnosed in 45.7% and Acute Lymphoblastic Leukemia (ALL) in 54.3% of the patients. There was no significant difference between FLAG-Ida and FLAG-Dauno groups in terms of patient characteristics, cytogenetic risk profiles, primary diagnoses and presence of primary refractory disease. Complete response rate and the number of patients bridged to allogeneic transplantation were similar in both groups. There was no significant difference in total survival between the two groups. In the side effect comparison between the two groups, the most common regimen-related toxicity in both groups was febrile neutropenia. No significant difference was found between the two groups in terms of Grade 3-4 side effects. In conclusion, FLAG-Dauno protocol is an effective and safe salvage regimen in relapsed/refractory acute leukaemia patients.

Anahtar Kelimeler

• ACUTE LEUKEMIA
• FLAG-IDA
• SALVAGE REGIMEN

FLAG-Ida’ya Karşı FLAG-Dauno: Relaps/Refrakter Akut Lösemi Olgularında Bursa Uludağ Üniversitesi Deneyimi

Öz

FLAG-Ida protokolü (Fludarabin- Sitarabin- Granülosit Koloni Stimülan Faktör- İdarubisin) relaps/refrakter akut lösemi olgularında sıklıkla uygulanan bir kemoterapi rejimidir. Özellikle ilaç erişiminde olan aksaklıklar nedeniyle, antrasiklin ajan olarak idarubisin yerine daunorubisin kullanılabilmektedir. Çalışmamızda, Bursa Uludağ Üniversitesi Hematoloji kliniğinde relaps/refrakter akut lösemi tanısı ile FLAG-Ida ya da FLAG-Dauno protokolü alan hastaların etkinlik ve yan etki verilerini değerlendirmeyi amaçladık. Çalışmaya toplam 94 hasta dahil edildi. On hasta FLAG-Dauno grubunda iken 84 hasta FLAG-Ida grubundaydı. Çalışma grubunun medyan yaşı 46.5 yıldı. Hastaların %45.7’si Akut Myeloid Lösemi (AML), %54.3’ü Akut Lenfoblastik Lösemi (ALL) tanılıydı. Hasta karekteristikleri, sitogenetik risk profilleri, primer tanıları ve primer refrakter hastalık varlığı açısından FLAG-Ida ve FLAG-Dauno grupları arasında anlamlı farklılık yoktu. İki grupta da komplet yanıt oranı ve allojeneik nakle köprülenen hasta sayıları benzer orandaydı. Toplam yaşam süreleri açısından iki grup arasında anlamlı farklılık saptanmadı. İki grup arasında yan etki karşılaştırmasında; iki grupta da en sık görülen rejim ilişkili toksisite febril nötropeniydi. Grade 3-4 yan etkiler açısından iki grup arasında anlamlı farklılık saptanmadı. Sonuç olarak FLAG-Dauno protokolü relaps/refrakter akut lösemi olgularında etkin ve güvenli bir kurtarma rejimidir.

Anahtar Kelimeler

• AKUT LÖSEMİ
• FLAG-Ida
• Kurtarma Tedavisi

Kaynakça

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