title: CLAG-based induction therapy in previously untreated high risk acute myeloid leukemia patients.
abstract: The CLAG regimen is highly active in patients with relapsed and/or refractory acute myeloid leukemia (AML). We administered CLAG-based chemotherapy to 20 previously untreated AML patients who were poor candidates for standard induction therapy. Responding patients received further CLAG as post-remission therapy followed by additional therapy that was tailored to their AML subtype. Patients were considered poor candidates for standard therapy due to either cardiac disease, prior chemotherapy for another malignancy, prior myeloproliferative disease, or myelodysplastic syndrome that had progressed after hypomethylator therapy. Overall, thirteen patients had a complete response (CR) to the first cycle of therapy (65%), one patient had a CR without platelet recovery, and 3 patients had a partial response (PR). Two of the patients with PR converted to CR after further therapy. The median duration of response has not been reached; the mean duration of response is 36.8 months (95% CI 28.8-44.8 months). Median overall survival (including deaths from all causes) is 29.0 months (95% CI 18.0-46.0 months). Patients with de novo AML had a CR rate of 90.9% and a median overall survival of 38.5 months. CLAG-based therapy is a well-tolerated, efficacious induction strategy in previously-untreated patients with high risk AML. CLAG-based regimens should be studied in a broader group of newly diagnosed AML patients.
authors.affiliation: Division of Hematology/Medical Oncology, New York Medical College, Valhalla, New York 10595, United States. Electronic address: karen_seiter@nymc.edu.
authors.forename: Karen
authors.initials: K
authors.lastname: Seiter
authors.affiliation: Division of Hematology/Medical Oncology, New York Medical College, Valhalla, New York 10595, United States.
authors.forename: Nasir
authors.initials: N
authors.lastname: Ahmed
authors.affiliation: Division of Hematology/Medical Oncology, New York Medical College, Valhalla, New York 10595, United States.
authors.forename: Azfar
authors.initials: A
authors.lastname: Shaikh
authors.affiliation: Division of Hematology/Medical Oncology, New York Medical College, Valhalla, New York 10595, United States.
authors.forename: Paul
authors.initials: P
authors.lastname: Baskind
authors.affiliation: Division of Hematology/Medical Oncology, New York Medical College, Valhalla, New York 10595, United States.
authors.forename: Delong
authors.initials: D
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D017338:Cladribine / Q000008:administration & dosage; D003561:Cytarabine / Q000008:administration & dosage; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage; D006801:Humans; D060828:Induction Chemotherapy / Q000379:methods*; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D012074:Remission Induction; D012306:Risk; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D003561:Cytarabine; D016179:Granulocyte Colony-Stimulating Factor; D017338:Cladribine
keywords: Acute myeloid leukemia; CLAG; Previously untreated; Secondary AML