title: CAG regimen enables relapsed or refractory T-cell acute lymphocytic leukemia patients to achieve complete remission: a report of six cases.
abstract: Patients with either relapsed or refractory T-cell acute lymphocytic leukemia (T-ALL) are candidates for allogeneic hematopoietic stem cell transplantation (allo-HSCT). Achieving complete remission (CR) in these patients is difficult but crucial for the success of allo-HSCT. In this study, we examined 6 relapsed or refractory T-ALL patients. In the patient group, 4 were male and 2 were female, with ages ranging from 15 to 57 years (median=29 years). All 6 patients presented with the nonmature T-ALL phenotype. Cytogenetically, only one had an i(7q) anomaly, whereas the remaining 5 cases had normal karyotypes. One of these patients had the MLL/AF9 fusion transcript, as shown by molecular study. After initial remission-induction therapy, two patients achieved CR, one showed a partial remission, and all relapsed soon. The other 3 cases failed the therapy. The CAG regimen (cytosine arabinoside 10 mg/m(2) subcutaneously every 12 hr, day 1-14; aclarubicin 5-7 mg/m(2) intravenously daily, day 1-8; and concurrent use of G-CSF 200 microg/m(2)/day subcutaneously) was devised originally for the treatment of relapsed acute myelogenous leukemia. After CAG therapy, all the T-ALL patients in our study achieved CR, indicating that the CAG regimen is beneficial to the treatment of relapsed or refractory T-ALL. The efficacy of CR-induction in T-ALL patients and the adverse effects of the CAG regimen need to be further studied.
authors.affiliation: Department of Hematology, the First Affiliated Hospital of Soochow University, Suzhou, China. xuesl@21cn.com
authors.forename: Sheng-Li
authors.initials: SL
authors.lastname: Xue
authors.forename: De-Pei
authors.initials: DP
authors.lastname: Wu
authors.forename: Ai-Ning
authors.initials: AN
authors.lastname: Sun
authors.forename: Xiao-Wen
authors.initials: XW
authors.lastname: Tang
mesh_terms: D015250:Aclarubicin / Q000008:administration & dosage; D000293:Adolescent; D000328:Adult; D015703:Antigens, CD / Q000235:genetics; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D003561:Cytarabine / Q000008:administration & dosage; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D016130:Immunophenotyping; D007621:Karyotyping; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000188:drug therapy* / Q000235:genetics; D008297:Male; D008875:Middle Aged; D012074:Remission Induction
chemical_list: D015703:Antigens, CD; D003561:Cytarabine; D016179:Granulocyte Colony-Stimulating Factor; D015250:Aclarubicin