doxorubicin + cytarabine + fludarabine + G-CSF + idarubicin + decitabine

This drug entry refers to a complex combination of chemotherapeutic agents and supportive factors evaluated within the **AML18 trial** (NCT02272478) sponsored by **Cardiff University**. The regimen includes the **FLAG-Ida** backbone (Fludarabine, Cytarabine, G-CSF, and Idarubicin) and the hypomethylating agent **Decitabine**, along with Doxorubicin (though Daunorubicin is more standard in this trial's DA arm). The combination is designed to treat older patients (typically over 60) with **Acute Myeloid Leukemia (AML)** or high-risk **Myelodysplastic Syndrome (MDS)**. The mechanism involves a multi-pronged attack: Fludarabine increases the accumulation of the active metabolite of Cytarabine (Ara-CTP) in leukemic blasts; G-CSF (Granulocyte Colony-Stimulating Factor) is used to 'prime' blasts into the cell cycle to increase sensitivity to chemotherapy; Idarubicin and Doxorubicin/Daunorubicin are anthracyclines that inhibit topoisomerase II and intercalate DNA; and Decitabine induces DNA hypomethylation to restore normal gene expression and promote cell differentiation.

Other names

FLAG-Ida plus DecitabineAML18 trial regimenAML-18 trial regimenAML 18 trial regimen