cladribine + aclarubicin + cytarabine + filgrastim + mitoxantrone

CLAAG-M is an intensive salvage chemotherapy regimen investigated for the treatment of relapsed or refractory acute myeloid leukemia (AML). The regimen is a combination of five agents: cladribine (a purine nucleoside analog), aclarubicin (an anthracycline), cytarabine (Ara-C, a pyrimidine nucleoside analog), granulocyte colony-stimulating factor (G-CSF, such as filgrastim), and mitoxantrone (an anthracenedione). The mechanism of action involves the synergistic cytotoxic effects of antimetabolites and topoisomerase II inhibitors, which disrupt DNA synthesis and integrity. A key feature of the regimen is the inclusion of G-CSF, which serves to "prime" quiescent leukemic blasts by stimulating their entry into the cell cycle, thereby increasing their susceptibility to the S-phase-specific agents cladribine and cytarabine. This regimen has been primarily studied in multicenter clinical trials in China as a salvage therapy for patients who have failed prior induction treatments.

Other names

CLAAG-M regimen