Low-dose cytarabine and aclarubicin in combination with granulocyte colony-stimulating factor (CAG regimen) for previously treated patients with relapsed or primary resistant acute myelogenous leukemia (AML) and previously untreated elderly patients with AML, secondary AML, and refractory anemia with excess blasts in transformation

We used the CAG regimen (low-dose cytarabine [10 mg/m(2) per 12 hours, days 1-14], aclarubicin [14 mg/m(2) per day, days 1-4], and granulocyte colony- stimulating factor [200 mu g/m(2) per day, days 1-14]) for the treatment of patients with primary resistant acute myelogenous leukemia (AML) and previ ously untreated elderly patients with AML, secondary AML, and refractory an emia with excess blasts in transformation (RAEB-T) in addition to relapsed AML. Forty-three of 69 (62%) patients achieved complete remission (CR), inc luding 29 of 35 (83%) patients with relapsed AML, 1 of 8 patients with prim ary resistant AML, 5 of 8 elderly patients with previously untreated AML, a nd 8 of 18 patients with previously untreated secondary AML or RAEB-T. Ten of 22 (45%) patients greater than or equal to 65 years old achieved CR. The patients who achieved CR received at least 1 course of modified CAG therap y as the first consolidation therapy, followed by various second consolidat ion and intensification therapies. The median disease-free survival and ove rall survival were 8 and 15 months, respectively, for relapsed AML; 11 and 8 months for the elderly patients; and 8 and 17 months for secondary AML an d RAEB-T; Myelosuppression was mild to moderate, and other than fever, seve re nonhematologic toxicity was rare. CAG as the induction therapy seems pro mising for the treatment of various categories of poor-prognosis AML. Int J Hematol. 2000;71:238-244 (C) 2000 The Japanese Society of Hematology.