cytarabine + daunorubicin + fludarabine

This is a combination chemotherapy regimen consisting of three drugs: cytarabine, daunorubicin (often in liposomal form), and fludarabine. The regimen is used primarily for the treatment of relapsed or refractory acute leukemia. Fludarabine and cytarabine work synergistically, as fludarabine (a ribonucleotide reductase inhibitor) increases the concentration of Ara-CTP (the active metabolite of cytarabine) in myeloblasts. Daunorubicin is antimitotic and cytotoxic, forming complexes with DNA, inhibiting topoisomerase II activity, inhibiting DNA polymerase activity, affecting gene expression regulation, and producing DNA-damaging free radicals. Cytarabine affects cells during the synthesis phase of cell division by inhibiting DNA polymerase. Fludarabine enhances the cytotoxic effects of cytarabine.

Other names

FLAD regimen