The CAG regimen (low-dose cytarabine, aclarubicin hydrochloride and granulocyte colony-stimulating factor) for the treatment of elderly acute myelomonocytic leukaemia: A case study

Elderly patients with acute myelomonocytic leukaemia (AMMoL) frequently hav e a poor quality of life after induction of remission using high-intensity treatment; we seek a more appropriate regimen for such patients. An 86-year -old man was hospitalized with a diagnosis of AMMoL (FAB classification M4) , of abnormal karyotype, and complications of diabetes mellitus and complet e right bundle branch block. He was treated with CAG therapy (cytarabine 10 mg/m(2) subcutaneously every 12 h for 14 consecutive days; aclarubicin hyd rochloride 10 mg/m2 per day, bolus intravenously for 4 consecutive days; gr anulocyte colony-stimulating factor 100 mug/day, subcutaneous injection for 14 consecutive days) every 3 months. White blood cell counts were at their lowest (around 600 - 800/mul) 12 days after the end of therapy, but return ed to about 2000-2300/mul 30 days after stopping therapy. No symptoms of dr ug-related toxicity, except slight nausea, were found. Complete remission w ith a good quality of life was induced and lasted over 2 years suggesting t hat CAG therapy might prove effective in elderly patients with AMMoL.