Possible effect of medroxyprogesterone acetate (MPA) in lymphoid blast crisis of chronic myelogenous leukemia.
A patient with a lymphoid blast crisis of a chronic myelogenous leukemia (CML) was treated with vindesine, vincristine and prednisone. Blasts disappeared from the peripheral blood but persisted at a level of 60% in the bone marrow. After 5 weeks of continuous therapy, the patient became thrombopenic, and 2 weeks later blasts rose to 31%. After 7 weeks, 1 g MPA was given daily p.o. and weekly vincristine treatment was resumed. Blasts disappeared again from the peripheral blood, thrombocytes rose to a maximum of 274 g/l, and a remission with less than 5% blasts was demonstrated in the bone marrow. In another relapse after withdrawal of MPA, estrogen and progesterone receptors (PR) were found in the leukemic cells. Thus, a remission was seen during treatment with vincristine, prednisone, and MPA after a deterioration with vincristine and prednisone alone in a PR-positive leukemia, and an effect of MPA in this lymphoid blast crisis of a CML has to be discussed.
Fink
M
M
Klinikum, Medizinische Klinik, Fürth, Germany.
D001752:Blast Crisis; D001773:Blood Cells / Q000473:pathology; D001853:Bone Marrow / Q000473:pathology; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy* / Q000473:pathology*; D017258:Medroxyprogesterone Acetate / Q000627:therapeutic use*; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use; D014750:Vincristine / Q000627:therapeutic use
D014750:Vincristine; D017258:Medroxyprogesterone Acetate; D011241:Prednisone