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Relapsed or refractory acute myeloid leukemia


  • Cladribine (2-CdA) 5 mg/m2/d iv over 2 hrs d1-5
  • Cytarabine (Ara-C) 2 g/m2/d iv over 4 hrs starting 2 hrs after cladribine d1-5
  • Mitoxantrone (Novantrone) 10 mg/m2/d iv d1-3
  • Filgrastim (Neupogen) 300 mcg sc d0-5

If PR, a second course of CLAG-M is given
Once CR achieved, proceed with following consolidation chemotherapy
Course 1

  • Cytarabine (Ara-C) 1.5 g/m2/d iv d1-3
  • Mitoxantrone (Novantrone) 10 mg/m2/d iv d3-5

Course 2

  • Cytarabine (Ara-C) 2 g/m2 iv q12h x 6 doses d1, 3, 5


Wierzbowska A et al. Cladribine combined with high doses of arabinoside cytosine, mitoxantrone, and G-CSF (CLAG-M) is a highly effective salvage regimen in patients with refractory and relapsed acute myeloid leukemia of the poor risk: a final report of the Polish Adult Leukemia Group. Eur J Haematol 2008; 80:115