Modulation of AraC by Fludarabine: Results of Salvage Therapy by AMLCG

Fludarabine was shown to increase the intracellular formation of AraCTP during treatment with AraC both in vitro and in vivo and had significant activity in patients with advanced acute myeloid leukemia (AML) when used in combination with AraC in phase II studies. However, the efficacy of fludarabin as chemo-modulatior of the AraC metabolism has not yet been assessed in phase III studies. Based on the S-HAI salvage regimen comprizing high-dose AraC q 12 hours on days 1,2,8, and 9 and idarubicin on days 3,4,10, and 11, the German AML Cooperative Group initiated a prospective randomized comparison between fludarabine q 12 hours on days 1, 2, 8, and 9 in addition to S-HAI as compared with S-HA…