cytarabine + idarubicin + GM-CSF + tioguanine + lomustine + mitoguazone

This multi-drug chemotherapy regimen served as the control arm in the GOELAMS SA4 (French Innovative Leukemia Organisation) Phase 3 clinical trial, which evaluated the addition of fludarabine to standard intensive therapy in elderly patients (ages 60-75) with de novo acute myeloid leukemia (AML). The regimen consists of three distinct phases: an induction phase utilizing cytarabine, idarubicin, and GM-CSF (molgramostim); a consolidation phase with intermediate-dose cytarabine and idarubicin; and a one-year maintenance phase involving 6-thioguanine and cytarabine, interspersed with re-induction courses of lomustine (CCNU), mitoguazone, and cytarabine. The combination targets leukemic cells through multiple mechanisms, including DNA synthesis inhibition, DNA intercalation, and alkylation, while GM-CSF is included to potentially sensitize blasts or accelerate hematologic recovery.

Other names

no fludarabine-French Innovative Leukemia Organisation-acute myeloid leukemiaGOELAMS SA4 control regimen