title: Successful Cytoreduction with CAG (cytarabine, Aclarubicin and G-CSF) Therapy in Refractory Acute Myelogenous Leukemia before Allogeneic Stem Cell Transplantation.
abstract: Refractory acute myelogenous leukemia (AML) has a poor prognosis, and a long-term survival cannot be expected in most patients even if allogeneic bone marrow transplantation (allo-BMT) or allogeneic peripheral blood stem cell transplantation (allo-PBSCT) is performed. An abundance of residual leukemic cells and poor performance status of patients before allo-BMT are often associated with a high relapse rate and high transplant-related mortality. Thus, to improve the prognosis of patients with refractory AML undergoing allo-BMT, it is necessary to reduce the leukemic cell volume as low as possible without severe complications. In this report, we used CAG (cytarabine, aclarubicin and granulocyte colony-stimulating factor (G-CSF)) therapy for cytoreduction before allo-BMT or allo-PBSCT in five patients with refractory AML. One of them achieved complete remission (CR) by CAG therapy alone and others achieved major tumor reduction prior to BMT and PBSCT. All patients achieved CR after allo-BMT and allo-PBSCT without severe complications. Three of them have remained CR for 9, 21 and 30 months, respectively. Although the results of this feasibility study are preliminary, the pre-transplant CAG therapy for refractory AML deserves further evaluation.
authors.affiliation: a Division of Hematology/Oncology, Department of Medicine, Hyogo Medical Centre for Adults , 13-70, Kita-Oji, Akashi Hyogo 673-8558 , Japan.
authors.forename: T
authors.initials: T
authors.lastname: Murayama
authors.affiliation: a Division of Hematology/Oncology, Department of Medicine, Hyogo Medical Centre for Adults , 13-70, Kita-Oji, Akashi Hyogo 673-8558 , Japan.
authors.forename: S
authors.initials: S
authors.lastname: Imoto
authors.affiliation: a Division of Hematology/Oncology, Department of Medicine, Hyogo Medical Centre for Adults , 13-70, Kita-Oji, Akashi Hyogo 673-8558 , Japan.
authors.forename: H
authors.initials: H
authors.lastname: Gomyo
authors.affiliation: a Division of Hematology/Oncology, Department of Medicine, Hyogo Medical Centre for Adults , 13-70, Kita-Oji, Akashi Hyogo 673-8558 , Japan.
authors.forename: I
authors.initials: I
authors.lastname: Mizuno
authors.affiliation: a Division of Hematology/Oncology, Department of Medicine, Hyogo Medical Centre for Adults , 13-70, Kita-Oji, Akashi Hyogo 673-8558 , Japan.
authors.forename: K
authors.initials: K
authors.lastname: Kajimoto
authors.affiliation: a Division of Hematology/Oncology, Department of Medicine, Hyogo Medical Centre for Adults , 13-70, Kita-Oji, Akashi Hyogo 673-8558 , Japan.
authors.forename: T
authors.initials: T
authors.lastname: Sugimoto
authors.affiliation: b Hematology Division , National Cancer Center Hospital , 5-1-1, Tsukiji, Chuoku, Tokyo , 104-0045 , Japan.
authors.forename: K
authors.initials: K
authors.lastname: Tobinai
authors.affiliation: a Division of Hematology/Oncology, Department of Medicine, Hyogo Medical Centre for Adults , 13-70, Kita-Oji, Akashi Hyogo 673-8558 , Japan.
authors.forename: T
authors.initials: T
authors.lastname: Koizumi
mesh_terms: D015250:Aclarubicin / Q000008:administration & dosage; D000293:Adolescent; D000328:Adult; D064591:Allografts; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D016026:Bone Marrow Transplantation; D003561:Cytarabine / Q000008:administration & dosage; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000628:therapy*; D008297:Male; D036102:Peripheral Blood Stem Cell Transplantation; D012074:Remission Induction
chemical_list: D003561:Cytarabine; D016179:Granulocyte Colony-Stimulating Factor; D015250:Aclarubicin
keywords: Allogeneic stem cell transplantation; CAG therapy; Refractory AML