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Comparison of fludarabine-containing salvage chemotherapy regimens for relapsed/refractory acute myelogenous leukemia

Leukemia volume 17, pages 990–993 (2003)Cite this article

TO THE EDITOR

Previous work demonstrated statistically significant association between arabinose-cytidine triphosphate (ara-CTP) accumulation by leukemic myeloblasts and probability of response to ara-C in dose ⩾1 gm/m2. Fludarabine is a deoxyadenosine analogue (2-fluoro-ara-AMP, FAMP) arabinosylcytosine that is rapidly dephosphorylated in vivo to 2-fluoro-ara-A. Intracellularly, it is phosphorylated to 2-fluoro-ara-ATP(FATP) by deoxycytidine (dCyd) and other kinases. Fludarabine has been postulated to be synergistic with arabinosylcytosine (ara-C), as a result of its effects on dCydkinase [deoxycytidine], which increase intracellular ara-CTP accumulation. We have reported that fludarabine (30 mg/m2) + ara-C (0.5 g/m2/h for 2–6 h daily) administered once daily for 5 days was superior to high-dose ara-C (HDAC: 3 gm/m2 over 2 h every 12 h for 2–6 days) in acute myelogenous leukemia (AML) in relapse after an initial complete remission (CR) duration > 1 year.1

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Authors and Affiliations

  1. Division of Cancer Medicine, Houston, TX, USA

    M B Thomas

  2. Department of Leukemia, Houston, TX, USA

    C Koller, S O'Brien, H Kantarjian, J Davis & E Estey

  3. Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Y Yang & Y Shen

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  1. M B Thomas
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  2. C Koller
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  8. E Estey
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Thomas, M., Koller, C., Yang, Y. et al. Comparison of fludarabine-containing salvage chemotherapy regimens for relapsed/refractory acute myelogenous leukemia. Leukemia 17, 990–993 (2003). https://doi.org/10.1038/sj.leu.2402862

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