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Treatment Name: FLAM (Fludarabine + Cytarabine + Mitoxantrone)

FLAM (Fludarabine + Cytarabine + Mitoxantrone) is a Chemotherapy Regimen for Acute Lymphoid Leukemia (ALL)

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1) Giebel S, Krawczyk-Kulis M, Adamczyk-Cioch M, et al. Fludarabine, cytarabine, and mitoxantrone (FLAM) for the treatment of relapsed and refractory adult acute lymphoblastic leukemia. A phase study by the Polish Adult Leukemia Group (PALG). Ann Hematol. 2006;85:717-722.

Created: February 21, 2019 Updated: February 21, 2019

What is Acute Lymphoid Leukemia (ALL)?

Acute Lymphoid Leukemia (ALL), also known as acute lymphoblastic leukemia, is a disease of the lymphoid cells found in the bone marrow. Lymphoid cells are responsible for developing into cells of the immune system called B-cells, T-cells, or Natural Killer cells. In ALL, immature lymphoid cells know as "blasts" replicate at a very fast rate. Sometimes blasts crowd out the normal cells in the bone marrow so that red blood cells or platelets are unable to develop.

Common symptoms of ALL include fatigue, infection, and bruising or bleeding. ALL is the most common cancer diagnosed in children, but is rare in adults. Most cases of ALL are considered "de novo" meaning that the cause is unknown; however, some cases can be linked to certain genetic syndromes. There is no staging system for ALL. Chromosomes are often analyzed to determine which mutations in the chromosomes exist. The effectiveness of the treatment may depend upon the specific chromosome mutations that are present.

NOTE: Treatment Options listed below are not all-inclusive. Other treatments may be available. ChemoExperts provides drug information and does not recommend any one treatment over another. Only your Doctor can choose your therapy.

Common FLAM starting doses

  • Fludarabine 15 mg/m2 intravenous (I.V.) infusion over 30 minutes every 12 hours on Days 1, 2, 8, and 9
  • Cytarabine 100 mg/m2 I.V. infusion over 45 minutes every 3 hours on Days 1, 2, 8, and 9
  • Mitoxantrone 10 mg/m2 I.V. infusion over 20 minutes on Days 3 and 10