title: [The comparative study of the effects between modified FLAG and CAG on relapsed or refractory acute myeloid leukemia].
abstract: OBJECTIVE
  To investigate the efficacy and toxicity of modified FLAG and CAG on relapsed or refractory acute myeloid leukemia (AML).
  
  
  METHODS
  Sixty-one patients with relapsed or refractory AML were divided into modified FLAG or CAG group. In modified FLAG group: G-CSF 200 μg·m⁻²·d⁻¹ on days 0-5; fludarabine 30 mg·m⁻²·d⁻¹ on days 1-5; Ara-C 1.0 g·m⁻²·d⁻¹ on days 1-5. In CAG group: Ara-C 10 mg·m⁻²·12 h⁻¹ on days 1-14, aclarubicin 20 mg/d on days 1-4, G-CSF 200 μg·m⁻²·d⁻¹ on days 0 1-14.
  
  
  RESULTS
  The complete response (CR) rate was 43% (12/28) and the partial response (PR) rate 18% (5/28) with the overall response (OR) rate of 61% in modified FLAG group. CR rate was 21% (7/33) and PR rate 15% (5/33) with OR rate of 36% in CAG group. There was significant statistical difference between two groups (P<0.05). The main toxicities of these groups were myelosupression and infection. The infection rate was 68% (19/28) in modified FLAG group (twenty-two patients were treated in the sterile laminar flow ward duing neutropenic period), treatment related mortality (TRM) in modified FLAG group was 7%; The infection rate was 55% (18/33) in CAG group (no patient was treated in the sterile laminar flow ward), TRM in CAG group was 3%. There was no significant statistical difference in two groups (P>0.05).
  
  
  CONCLUSIONS
  Modified FLAG was effective for relapsed or refractory AML. The supportive cares to strengthen infection-controlled measures and shorten the period of bone marrow suppression produced the additional effect. CAG regimen has low adverse reactions and could be individualized to elder or weak patients.
authors.affiliation: Department of Hematology, Shanxi Da Yi Hospital of Shanxi Medical University, Taiyuan, Shanxi　030032, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Wang
authors.affiliation: Department of Hematology, Shanxi Da Yi Hospital of Shanxi Medical University, Taiyuan, Shanxi　030032, China.
authors.forename: Liangming
authors.initials: L
authors.lastname: Ma
authors.affiliation: Department of Hematology, Shanxi Da Yi Hospital of Shanxi Medical University, Taiyuan, Shanxi　030032, China.
authors.forename: Qiujuan
authors.initials: Q
authors.lastname: Zhu
authors.affiliation: Department of Hematology, Shanxi Da Yi Hospital of Shanxi Medical University, Taiyuan, Shanxi　030032, China.
authors.forename: Rong
authors.initials: R
authors.lastname: Gong
authors.affiliation: Department of Hematology, Shanxi Da Yi Hospital of Shanxi Medical University, Taiyuan, Shanxi　030032, China.
authors.forename: Zhilin
authors.initials: Z
authors.lastname: Gao
authors.affiliation: Department of Hematology, Shanxi Da Yi Hospital of Shanxi Medical University, Taiyuan, Shanxi　030032, China.
authors.forename: Weiwei
authors.initials: W
authors.lastname: Tian
mesh_terms: D015250:Aclarubicin; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003561:Cytarabine; D016179:Granulocyte Colony-Stimulating Factor; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy*; D012008:Recurrence
chemical_list: D003561:Cytarabine; D016179:Granulocyte Colony-Stimulating Factor; D015250:Aclarubicin