{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T14:22:44Z","timestamp":1782829364301,"version":"3.54.5"},"reference-count":36,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T00:00:00Z","timestamp":1776816000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T00:00:00Z","timestamp":1776816000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    In a large multicenter real\u2010world cohort, we aimed to evaluate outcomes of FLAG\u2010Ida salvage therapy for relapsed\/refractory\u00a0(R\/R) acute myeloid leukemia (AML) and validated the SALFLAGE prognostic score. We analyzed 1079 adults with\u00a0R\/R AML treated across 112 PETHEMA institutions over 26\u2009years (1998\u20132024), including patients with primary refractory disease\u00a0(36.9%) and first relapse episode (63.1%), with a median age of 52\u2009years. Complete remission composite (CRc) was achieved 56.8%, including complete remission (CR) in 51.0%, CR with incomplete recovery in 4.0%, and morphological\u2010free\u2010state in 1.8%, enabling 35.2% of patients and 62% of responders to proceed to allogeneic transplantation without morphological disease. With median follow\u2010up of 50.9\u2009months, median overall survival (OS) was 10.2\u2009months, with 5\u2010year OS rate of 21.6%. Prior allogeneic transplantation (HR 0.54;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001) and relapse\u2010free interval \u2265\u20091\u2009year (HR 0.75;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.024) independently predicted improved OS, whereas modified high\u2010risk cytogenetics including\n                    <jats:italic>t<\/jats:italic>\n                    (8; 21) (HR 3.58;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001),\n                    <jats:italic>FLT3<\/jats:italic>\n                    \u2010ITD mutation at primary diagnosis (HR 1.61;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001), and age\u2009\u2265\u200960 (HR 1.43;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001) conferred inferior OS. Validation of the SALFLAGE score demonstrated moderate discrimination (C\u2010index 0.67), with 5\u2010year survival of 38.4%, 27.2%, and 12.7% across risk categories (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). Outcomes improved over periods (1998\u20132005 vs. 2006\u20132016 vs. 2017\u20132024): 30\u2010day mortality was 6.9% vs. 9.3% vs. 5.0%, respectively (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.030), and median OS was 7.8 versus 9.4 versus 11.1\u2009months, respectively\u00a0(\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.16). We confirm FLAG\u2010Ida as a reference salvage regimen in fit R\/R AML and validate the SALFLAGE score in this setting.\n                  <\/jats:p>","DOI":"10.1002\/ajh.70340","type":"journal-article","created":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T11:50:02Z","timestamp":1776858602000},"page":"1692-1705","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Real\u2010World Outcomes of\n                    <scp>FLAG<\/scp>\n                    \u2010Ida Regimen in 1079 Adult Patients With First Relapsed\/Refractory\n                    <scp>AML<\/scp>\n                    : A\n                    <scp>PETHEMA<\/scp>\n                    Study"],"prefix":"10.1002","volume":"101","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9033-575X","authenticated-orcid":false,"given":"Gaspar","family":"Aspas Requena","sequence":"first","affiliation":[{"name":"Service d'H\u00e9matologie Clinique Montpellier University Hospital  Montpellier France"},{"name":"University of Montpellier  Montpellier France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2139-8540","authenticated-orcid":false,"given":"Rebeca","family":"Rodr\u00edguez\u2010Veiga","sequence":"additional","affiliation":[{"name":"Servicio de Hematolog\u00eda, Hospital U. 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