Rescue treatment in refractory or relapsed acute leukemia with the IDA-FLAG scheme: Experience in routine services

Objectives: To describe complete remission rates in patients with refractory or relapsed acute leukemia following the IDA-FLAG scheme, and establish the overall and event free survival, toxicity and duration of the complete remission. Methods: Retrospective analysis of patients over 15 years old. Discrete and continuous variables are described by using frequencies and measures of central tendency. Overall and event free survival were determined with the Kaplan-Meier method using the log-Rank test for comparison among categories. Results: A total of 64 patients were included. There were no significant differences in the remission rate as regards sex, type of leukemia, or duration of the first remission. The toxicity was mainly hematological, and 100% of the patients had subsequent febrile neutropenia at the start of the treatment. The median overall survival was 5.83 months, and the event free survival was 79 days. Significant differences were found in the overall survival between the patient group that achieved complete remission and those that did not. Conclusions: Rescue treatment with the IDA-FLAG scheme managed to induce a complete remission in a significant percentage of patients with relapsed acute leukemia, with an acceptable toxicity, which was mainly hematological. Prospective studies are needed with a design suitable for validating its efficacy and to confirm our results. (c) 2013 Instituto Nacional de Cancerologia. Published by Elsevier Espana, S.L.U. All rights reserved.