CONCURRENT USE OF GRANULOCYTE-COLONY-STIMULATING FACTOR WITH LOW-DOSECYTOSINE-ARABINOSIDE AND ACLARUBICIN FOR PREVIOUSLY TREATED ACUTE MYELOGENOUS LEUKEMIA - A PILOT-STUDY

We used a new chemotherapy regimen for the treatment of 18 consecutive patients with relapsed AML (median age 44 years, range 18-74). The re gimen consisted of low-dose cytosine arabinoside (10 mg/m(2)/12 h, usu ally day 1 to 14), low-dose aclarubicin (10-14 mg/m(2)/day, day 1 to 4 ), and concurrent use of G-CSF (200 mu g/m(2)/day) (GAG regimen). Over all, 15/18 patients (83%) achieved complete remission (CR) after one o r two courses, including eight out of ten refractory patients with ear ly relapse, second or subsequent relapses, and/or resistant relapse. T wo of three patients who relapsed, achieved CR again after reinduction with a modified CAG regimen. Fourteen of the 15 complete remitters re ceived consolidation therapy with the CAG regimen modified, followed b y oral busulfan in eight cases, and by allogeneic bone marrow transpla ntation in two cases. At a median follow-up of 12 months, median CR du ration and survival were 6 months and 17 months, respectively. Myelosu ppression in the first course of induction therapy was moderate to sev ere. However, severe non-hematologic toxicity (WHO grade greater than or equal to 3) was characteristically rare. Although this is a prelimi nary study, the CAG combination seems promising for the treatment of r elapsed AML, with its low toxicity contributing to a higher quality of life for the patient.