CAG regimen enables relapsed or refractory T-cell acute lymphocytic leukemia patients to achieve complete remission: a report of six cases

Am J Hematol. 2008 Feb;83(2):167-70. doi: 10.1002/ajh.21066.

Abstract

Patients with either relapsed or refractory T-cell acute lymphocytic leukemia (T-ALL) are candidates for allogeneic hematopoietic stem cell transplantation (allo-HSCT). Achieving complete remission (CR) in these patients is difficult but crucial for the success of allo-HSCT. In this study, we examined 6 relapsed or refractory T-ALL patients. In the patient group, 4 were male and 2 were female, with ages ranging from 15 to 57 years (median=29 years). All 6 patients presented with the nonmature T-ALL phenotype. Cytogenetically, only one had an i(7q) anomaly, whereas the remaining 5 cases had normal karyotypes. One of these patients had the MLL/AF9 fusion transcript, as shown by molecular study. After initial remission-induction therapy, two patients achieved CR, one showed a partial remission, and all relapsed soon. The other 3 cases failed the therapy. The CAG regimen (cytosine arabinoside 10 mg/m(2) subcutaneously every 12 hr, day 1-14; aclarubicin 5-7 mg/m(2) intravenously daily, day 1-8; and concurrent use of G-CSF 200 microg/m(2)/day subcutaneously) was devised originally for the treatment of relapsed acute myelogenous leukemia. After CAG therapy, all the T-ALL patients in our study achieved CR, indicating that the CAG regimen is beneficial to the treatment of relapsed or refractory T-ALL. The efficacy of CR-induction in T-ALL patients and the adverse effects of the CAG regimen need to be further studied.

Publication types

  • Case Reports

MeSH terms

  • Aclarubicin / administration & dosage
  • Adolescent
  • Adult
  • Antigens, CD / genetics
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Cytarabine / administration & dosage
  • Female
  • Granulocyte Colony-Stimulating Factor / administration & dosage
  • Granulocyte Colony-Stimulating Factor / therapeutic use
  • Humans
  • Immunophenotyping
  • Karyotyping
  • Leukemia-Lymphoma, Adult T-Cell / drug therapy*
  • Leukemia-Lymphoma, Adult T-Cell / genetics
  • Male
  • Middle Aged
  • Remission Induction

Substances

  • Antigens, CD
  • Cytarabine
  • Granulocyte Colony-Stimulating Factor
  • Aclarubicin

Supplementary concepts

  • CAG protocol