decitabine + cladribine + cytarabine + granulocyte colony-stimulating factor

This is a four-drug combination chemotherapy regimen consisting of decitabine, cladribine, cytarabine, and granulocyte colony-stimulating factor (G-CSF). It is being investigated primarily for the treatment of relapsed or refractory acute myeloid leukemia (AML). Decitabine is a hypomethylating agent that inhibits DNA methyltransferase, leading to DNA hypomethylation and reactivation of silenced genes. Cladribine is a purine nucleoside analog that interferes with DNA synthesis and repair. Cytarabine is an antimetabolite that inhibits DNA polymerase during the S-phase of cell division. G-CSF stimulates the proliferation and differentiation of neutrophil precursors; in this context it may also "prime" leukemic cells to be more sensitive to chemotherapy by promoting their entry into the cell cycle. The combination aims to maximize anti-leukemic activity through synergistic effects on malignant myeloid cells while supporting hematopoietic recovery with G-CSF[7][1][5].

Other names

decitabine plus cladribine plus cytarabine plus G-CSFD-CLAG regimen