title: Low-dose cytarabine and aclarubicin in combination with granulocyte colony-stimulating factor (CAG regimen) for previously treated patients with relapsed or primary resistant acute myelogenous leukemia (AML) and previously untreated elderly patients with AML, secondary AML, and refractory anemia with excess blasts in transformation.
abstract: We used the CAG regimen (low-dose cytarabine [10 mg/m2 per 12 hours, days 1-14], aclarubicin [14 mg/m2 per day, days 1-4], and granulocyte colony-stimulating factor [200 micrograms/m2 per day, days 1-14]) for the treatment of patients with primary resistant acute myelogenous leukemia (AML) and previously untreated elderly patients with AML, secondary AML, and refractory anemia with excess blasts in transformation (RAEB-T) in addition to relapsed AML. Forty-three of 69 (62%) patients achieved complete remission (CR), including 29 of 35 (83%) patients with relapsed AML, 1 of 8 patients with primary resistant AML, 5 of 8 elderly patients with previously untreated AML, and 8 of 18 patients with previously untreated secondary AML or RAEB-T. Ten of 22 (45%) patients > or = 65 years old achieved CR. The patients who achieved CR received at least 1 course of modified CAG therapy as the first consolidation therapy, followed by various second consolidation and intensification therapies. The median disease-free survival and overall survival were 8 and 15 months, respectively, for relapsed AML; 11 and 8 months for the elderly patients; and 8 and 17 months for secondary AML and RAEB-T. Myelosuppression was mild to moderate, and other than fever, severe nonhematologic toxicity was rare. CAG as the induction therapy seems promising for the treatment of various categories of poor-prognosis AML.
authors.affiliation: Department of Hematology, Dokkyo University School of Medicine, Tochigi, Japan. k-saito@dokkyomed.ac.jp
authors.forename: K
authors.initials: K
authors.lastname: Saito
authors.forename: Y
authors.initials: Y
authors.lastname: Nakamura
authors.forename: M
authors.initials: M
authors.lastname: Aoyagi
authors.forename: K
authors.initials: K
authors.lastname: Waga
authors.forename: K
authors.initials: K
authors.lastname: Yamamoto
authors.forename: A
authors.initials: A
authors.lastname: Aoyagi
authors.forename: F
authors.initials: F
authors.lastname: Inoue
authors.forename: Y
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Y
authors.initials: Y
authors.lastname: Arai
authors.forename: J
authors.initials: J
authors.lastname: Tadokoro
authors.forename: T
authors.initials: T
authors.lastname: Handa
authors.forename: S
authors.initials: S
authors.lastname: Tsurumi
authors.forename: H
authors.initials: H
authors.lastname: Arai
authors.forename: Y
authors.initials: Y
authors.lastname: Kawagoe
authors.forename: H
authors.initials: H
authors.lastname: Gunnji
authors.forename: Y
authors.initials: Y
authors.lastname: Kitsukawa
authors.forename: W
authors.initials: W
authors.lastname: Takahashi
authors.forename: S
authors.initials: S
authors.lastname: Furusawa
mesh_terms: D015250:Aclarubicin / Q000008:administration & dosage / Q000633:toxicity; D000754:Anemia, Refractory, with Excess of Blasts / Q000188:drug therapy*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use* / Q000633:toxicity; D003561:Cytarabine / Q000008:administration & dosage* / Q000633:toxicity; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage / Q000633:toxicity; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy*; D008213:Lymphocyte Activation; D008297:Male; D016609:Neoplasms, Second Primary / Q000188:drug therapy; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D003561:Cytarabine; D016179:Granulocyte Colony-Stimulating Factor; D015250:Aclarubicin