title: Evidence for a selective antileukemic effect of cytosine arabinoside in chronic granulocytic leukemia.
abstract: On the basis of in-vitro studies indicating that low concentrations of cytosine arabinoside exert preferential inhibition of granulocyte-macrophage colony-forming cells from patients with chronic granulocytic leukemia vs normal subjects, we treated two outpatients with low doses of this agent, administered by subcutaneous infusion for 12-31 days. Both patients continued their usual activities, including employment, during these infusions. They exhibited only Ph-positive metaphases at entry into the protocol but in both cases, Ph-positive cells were reduced to approx. 10% of marrow metaphases, after 2-3 successive infusions. Both patients exhibited significant increases in Ph-positive cells, to 46 and 72% of marrow metaphases, during subsequent chemotherapy with hydroxyurea, in dosage sufficient to maintain granulocytopenia and a normal serum B12 level. After additional cytosine arabinoside, both patients again showed decreases in Ph-positive cells, to 7% (p less than 0.01) and 19% (p less than 0.0001), respectively. This clinical experience is consistent with the conclusion that cytosine arabinoside (but not, hydroxyurea) exerts a selective antileukemic effect in some patients with CGL.
authors.affiliation: Department of Medicine, Duke University Medical Center, Durham, NC 27710.
authors.forename: J E
authors.initials: JE
authors.lastname: Sokal
authors.forename: J P
authors.initials: JP
authors.lastname: Gockerman
authors.forename: S H
authors.initials: SH
authors.lastname: Bigner
mesh_terms: D000328:Adult; D001853:Bone Marrow / Q000473:pathology / Q000648:ultrastructure; D003561:Cytarabine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006918:Hydroxyurea / Q000008:administration & dosage / Q000627:therapeutic use; D007951:Leukemia, Myeloid / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D008297:Male; D010677:Philadelphia Chromosome; D010865:Pilot Projects; D012074:Remission Induction
chemical_list: D003561:Cytarabine; D006918:Hydroxyurea