Treatment of core-binding-factor in acute myelogenous leukemia with fludarabine, cytarabine, and granulocyte colony-stimulating factor results in improved event-free survival.

Abstract

BACKGROUND:

Acute myelogenous leukemia (AML) associated with core-binding-factor (CBF) abnormalities is the type of leukemia most responsive to cytarabine (ara-C) therapy and is of relative favorable prognosis. In vitro and ex vivo observations suggest that increases in intracellular ara-C levels influenced by administration of fludarabine and granulocyte colony-stimulating factor (GCSF) increase the effect of ara-C, prompting us to clinically evaluate the efficacy of such combinations.

METHODS:

We analyzed the event-free survival of patients with newly diagnosed CBF AML treated with fludarabine and ara-C (FA) (N = 45) or with FA and GCSF (FLAG) (N = 22) and compared results to patients treated with regimens consisting of idarubicin and ara-C with or without GCSF (IA/IAG) (N = 47).

RESULTS:

After accounting for prognostic covariates other than treatment (including year in which treatment was administered), FA, and in particular FLAG, were associated with longer event-free survival than IA/IAG.

CONCLUSIONS:

Thus, our data lends clinical credence to the observed modulation of ara-C by fludarabine and GCSF.

• Authors: Gautam Borthakur, Hagop Kantarjian, Xuemei Wang, William K Plunkett Jr, Varsha V Gandhi, Stefan Faderl, Guillermo Garcia-Manero, Farhad Ravandi, Sherry Pierce, Elihu H Estey
• Journal: Cancer (Cancer) Vol. 113 Issue 11 Pg. 3181-5 (Dec 01 2008) ISSN: 0008-543X [Print] United States
• PMID: 18932257 (Publication Type: Clinical Trial, Comparative Study, Journal Article)
• Copyright: (c) 2008 American Cancer Society

Chemical References

• Core Binding Factors
• Cytarabine
• Granulocyte Colony-Stimulating Factor
• Vidarabine
• Idarubicin

Topics

• Adolescent
• Adult
• Aged
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Core Binding Factors (metabolism)
• Cytarabine (therapeutic use)
• Disease-Free Survival
• Female
• Granulocyte Colony-Stimulating Factor (administration & dosage, therapeutic use)
• Humans
• Idarubicin (administration & dosage)
• Leukemia, Myeloid, Acute (drug therapy, metabolism, mortality)
• Male
• Middle Aged
• Multivariate Analysis
• Vidarabine (analogs & derivatives, therapeutic use)