[Refractory anemia with excess myeloblast in transformation induced remission by combined oral administration of cytarabine ocfosfate and 6-mercaptopurine].
A 55-year-old female presented with sore throat and slight fever. The patient was admitted to our hospital on December 13, 1993. Full blood count showed hemoglobin 10.7 g/dl, white cell count 960/microliters (neutrophils 14%, lymphocytes 82%, blasts 2%) and platelets 13,000/microliters. Bone marrow examination showed hypocellularity with 4.5% of myeloblast positive for peroxidase. The bone marrow specimens on Dec. 20 showed 15.5% of myeloblasts, some of which had Auer rods. These findings led to the diagnosis of refractory anemia with excess myeloblast in transformation (RAEB-T) of French-American-British Cooperative Group. The patient was transfused and treated with cytarabine ocfosfate (SP-AC) (100 mg tid) and 6-mercaptopurine (50 mg tid) for 14 days. During chemotherapy she complained of nausea and anorexia, but they were managed easily with medication. On Feb. 7, 1994, forty-two days after the start of administration, peripheral blood and bone marrow aspirate were compatible with a complete remission. Although complete remission was sustained with courses of chemotherapy for 4 months, relapse occurred and the patient died of septicemia on August 29, 1994 after induction failure. Observation suggested that oral SPAC in combination with 6-mercaptopurine had a good antileukemic effect on the myelodysplastic syndrome. However, the duration response was short, and further improvement of the therapy is needed.
Fukumi
S
S
Dept. of Internal Medicine I, Daisan Hospital, Jikei University School of Medicine.
Mizorogi
F
F
Matsuo
A
A
Sato
H
H
Abe
T
T
D000284:Administration, Oral; D000754:Anemia, Refractory, with Excess of Blasts / Q000097:blood / Q000188:drug therapy*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001088:Arabinonucleotides / Q000008:administration & dosage; D003568:Cytidine Monophosphate / Q000008:administration & dosage / Q000031:analogs & derivatives; D005260:Female; D006801:Humans; D015122:Mercaptopurine / Q000008:administration & dosage; D008875:Middle Aged; D012074:Remission Induction
D001088:Arabinonucleotides; C061162:1-arabinofuranosylcytosine-5'-stearylphosphate; D015122:Mercaptopurine; D003568:Cytidine Monophosphate