Efficacy and Safety of Azacytidine in combination with fludarabine and high-dose cytarabine with G-CSF (FLAG) in Relapsed/Refractory Acute Myeloid Leukemia: A Nonrandomized, Open-Label, Phase II Study

Relapsed and refractory adult acute myeloid leukemia (AML) is a challenging disease to treat with poor outcomes. There is no standard treatment for the AML in those settings, and incorporating new strategies is urgently needed. In AML, aberrant DNA methylation has been strongly associated with progression, relapse, and drug resistance. 1-3 These studies endorse the rationale to combine hypomethylating agents (HMAs), such as azacytidine (AZA), with high-intensity chemotherapy. At a low dose, HMAs act as DNA methyltransferase inhibitors (DNMTis), inducing global DNA hypomethylation, thereby activating tumor suppressors, downregulating oncogenes, promoting an innate antiviral immune response, and boosting sensitivity to cytotoxic agents, particularly to cytarabine.

Source: Clinical Lymphoma, Myeloma and Leukemia - July 28, 2021 Category: Hematology Authors: Ibraheem H. Motabi, Shaima M. Al Aoun, Maged Al-Ammari, Belal M. Albtoosh, Shahid Iqbal, Syed Y. Altaf, Imran K. Tailor, Mohammed S. Alnoamani, Mubarak S. AlGhamdi, Syed ZA Zaidi, Nawal F. AlShehry, Mohammed A. Marei, Mansour Alfayez Source Type: research