الفهرس 
Clinical Outcomes of IDA-FLAG protocol and its modifications in relapsed/refractory Acute Leukemias
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Abstract
Background Patients with relapsed/refractory acute leukemias have poor prognosis and the optimal treatment for these cases is controversial. Many agents have been used to achieve the desired goal of CR before HCST. IDA-FLAG protocol and its modifications are some of the widely used agents in this setting. The aim of this study is to determine the clinical outcomes of adopting such treatment in the National Cancer Institute, Egypt. Methods:This is a retrospective study including relapsed/refractory acute leukemias receiving IDA-FLAG or its modifications who presented to National Cancer Institute , Egypt from December2013 to December2017 . Results Through this period 95 patients were assessed.The median age was about 39 years ranging from 18 to 60 years of age, Performance Status (PS) ranging 1 (34.8%), 2 (51.7%), 3 (13.5%) respectively, with male predominance, 58 (61%), 31 (32.7%), 6 (6.3%) of patients were AML, ALL and MPAL respectively. These patients were further classified to high risk 16 patients (16.8%), intermediate 66 patients (69.5%), low risk 13 patients (13.7%) respectively according to their initial cytogenetic and molecular assay. CR/CRi accounted for nearly 32.7%, Death accounted for 34.7%, refractory disease still after FLAG-IDA in 24.2 %. 10 patients (10.5%) were referred to allo-SCT and Overall survival ranged from 0.03 months to 67.5 months with a median of 2.01 months.Cumulative overall survival was 42.1% at 3 months and 24.2 % at 6 months and only 2 patients remained alive. Toxicity profiles were variable but G3-G4 hematological toxicity almost occurred in all patients.