COMPARATIVE RANDOMIZED STUDY OF PROTOCOL HAM VERSUS PROTOCOL FLAG IN RELAPSED/REFRACTORY ACUTE MYELOID LEUKEMIA
Author(s): ,
alyaa R.elsergany
Affiliations:
Medical oncology,oncology center,Mansoura University,Mansoura,Egypt
,
maha ibrahim ismaeel
Affiliations:
Medical oncology,oncology center,Mansoura University,Mansoura,Egypt
,
mohamed A. ibrahim
Affiliations:
Medical oncology,oncology center,Mansoura University,Mansoura,Egypt
,
hayam F. Ghazy
Affiliations:
Medical oncology,oncology center,Mansoura University,Mansoura,Egypt
doaa A. aladle
Affiliations:
clinical pathology,faculty of medicine,Mansoura,Egypt
EHA Library. elsergany A. Jun 15, 2019; 266666; PS1049
Alyaa elsergany
Alyaa elsergany
Contributions
Abstract

Abstract: PS1049

Type: Poster Presentation

Presentation during EHA24: On Saturday, June 15, 2019 from 17:30 - 19:00

Location: Poster area

Background
Acute myeloid leukemia (AML) is the commonest type of acute leukemias in adults resulting from clonal proliferation of bone marrow precursor cells with disruption of hemostasis. Patients initially respond to induction therapy but the majority of patients suffer relapse and refractoriness with very poor subsequent prognosis.

Aims

To compare two widely used salvage regimens in treatment of relapsed/refractory AML, HAM (cytarabine, Mitoxantrone, Colony stimulating factor) versus FLAG (cytarabine, fludarabine, Colony stimulating factor) protocols.

Methods
Prospective randomized study included 90 patient diagnosed as relapsed/refractory AML were selected from Oncology Center, Mansoura University, Egypt, from January 2014 to December 2017. Patients received salvage therapy either HAM or FLAG protocol, then outcomes regarding to efficacy, side effects and overall survival were assessed.

Results
Ninety patients were included in our study, 43 patients received HAM protocol versus 47 received FLAG protocol. Complete remission (CR) was 42.6% in HAM group versus 48.8% in FLAG group (p=0.5). On the other hand, hepatic impairment was 46.8% in HAM group versus 30.3% in FLAG group (p=0.2). Also, renal impairment was 6.4% in HAM group versus 18.6% in FLAG group (p=0.07). In addition, Event free survival (EFS) was higher in FLAG vs. HAM arms (9 versus 4 months, p=0.2). Lastly, overall survival (OS) in HAM group was shorter than in FLAG group (3 vs. 5 months, P=0.09)

Conclusion
Both HAM and FLAG protocols are adequate salvage chemotherapy in relapsed/refractory AML, with different toxicity profile as HAM has more hepatotoxicity while FLAG is more nephrotoxic, CR was slightly higher with FLAG with more survival benefit compared with HAM protocol.

Session topic: 4. Acute myeloid leukemia - Clinical

Keyword(s): Acute myeloid leukemia

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