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  • Title: Treatment of core-binding-factor in acute myelogenous leukemia with fludarabine, cytarabine, and granulocyte colony-stimulating factor results in improved event-free survival.
    Author: Borthakur G, Kantarjian H, Wang X, Plunkett WK, Gandhi VV, Faderl S, Garcia-Manero G, Ravandi F, Pierce S, Estey EH.
    Journal: Cancer; 2008 Dec 01; 113(11):3181-5. PubMed ID: 18932257.
    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.
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