FLAG with Bortezomib Salvage Therapy in Relapsed/Refractory Childhood Leukemia—A Reliable Bridge to Transplantation with Limited Toxicity

Relapsed refractory leukemia represents a difficult-to-treat population of patients. The balance between perceived benefit and potential side effects along with the significant financial burden of managing multidrug-resistant sepsis are factors that determine the choice of salvage regimen. Here, we...

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Bibliographic Details
Published in:South Asian journal of cancer 2024-04
Main Authors: Cherulil, Sreedhar Jayakrishnan, Melarcode Ramanan, Kesavan, Gangadharan, KV, Sreelesh, KP, Chandrashekaran, Arun, Vaniyath, Sudeep, KV, Karthika
Format: Article
Language:English
Subjects:
childhood leukemia
FLAG
neutropenia
relapsed leukemia
salvage chemotherapy
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Summary:Relapsed refractory leukemia represents a difficult-to-treat population of patients. The balance between perceived benefit and potential side effects along with the significant financial burden of managing multidrug-resistant sepsis are factors that determine the choice of salvage regimen. Here, we present our experience with the combination of fludarabine, cytarabine, granulocyte-colony stimulating factor with bortezomib. The morphological complete response rate was 58% with 50% of the patients achieving complete remission. With only three patients requiring intensive care unit admission during remission induction, 66.6% of the patients went on to undergo successful hematopoietic stem cell transplantation. Thus, it proved to be a possible, safer alternative to other salvage regimens, while enabling a significant percentage of patients to achieve remission and proceed to allogenic stem cell transplantation.
ISSN:2278-330X
2278-4306
DOI:10.1055/s-0044-1785695