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Kolb, H.J. ; Schmid, C.*

The FLAMSA concept-past and future.

Ann. Hematol. 99, 1979–1988 (2020)
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The FLAMSA reduced intensity (RIC) concept, also known as "sequential therapy", is a conceptual platform for the treatment of leukemia separated in several parts: induction therapy, a sequence of antileukemic and immunosuppressive conditioning for allogeneic stem cell transplantation, and immune restitution supported by donor lymphocyte transfusions. The antileukemic part consists of fludarabine, cytosine arabinoside, and amsacrine (FLAMSA); non-cross reactive agents like fludarabine and amsacrine have been successfully used in cases of refractoriness and relapse. Immunosuppressive conditioning and transplantation follow after only 3 days of rest. This way, the toxicity of allogeneic transplantation could be reduced and the anti-leukemia effects by using allogeneic immune cells could be optimized. This review summarizes available data on efficacy and toxicity of this approach. Further, possible strategies for improvements are discussed in order to provide better chances for elderly and frail patients and patients with advanced and high-risk disease. Among others, several new agents are available that target molecular changes of leukemia for induction of remission and allow for bridging the time after transplantation until adoptive immunotherapy becomes safe and effective.
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Publication type Article: Journal article
Document type Review
Keywords Aml ; Mds ; Transplantation ; Conditioning ; Flamsa ; Dli ; Graft Versus Leukemia ; Targeted Therapy; Acute Myeloid-leukemia; Stem-cell Transplantation; Versus-host-disease; Bone-marrow-transplantation; Chronic Myelogenous Leukemia; Donor Lymphocyte Infusions; Minimal Residual Disease; Acute Nonlymphocytic Leukemia; Low-dose Cytarabine; Adoptive Immunotherapy
Language english
Publication Year 2020
HGF-reported in Year 2020
ISSN (print) / ISBN 0939-5555
e-ISSN 1432-0584
Journal Annals of Hematology
Quellenangaben Volume: 99, Issue: , Pages: 1979–1988 Article Number: , Supplement: ,
Publisher Springer
Publishing Place One New York Plaza, Suite 4600, New York, Ny, United States
Reviewing status Peer reviewed
Institute(s) CCG Immunotherapy (KKG-KIT)
POF-Topic(s) 30504 - Mechanisms of Genetic and Environmental Influences on Health and Disease
Research field(s) Immune Response and Infection
PSP Element(s) G-520360-001
DOI 10.1007/s00277-020-04131-1
WOS ID WOS:000543687800002
Scopus ID 85086908756
PubMed ID 32594216
Erfassungsdatum 2020-07-08
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