[Low-dose combination cytarabine and etoposide for myeloid crisis transformed from unclassified chronic myeloproliferative disorder].
A 65-year-old man visited our department for further leukocytosis examination. Hematological examinations disclosed elevation of the leukocyte count with left deviation. The neutrophilic alkaline phosphatase score was reduced. Bone marrow was hypercellular and consisted almost entirely of granulocytic cells in all stages of maturation. However, cytogenetic analysis revealed no Philadelphia chromosome, and genotypic analysis disclosed no bcr rearrangement. He was ultimately diagnosed as having unclassified chronic myeloproliferative disorder. He had been followed without chemotherapy, and he developed blastic crises (CD10+, CD13+, CD24+). Chemotherapy was effective, and then he was followed with carboquone. However, myeloid crisis (CD13+, CD33+) developed again. Standard chemotherapies had no effect, he developed pneumonia, and he was in poor general condition. Therefore, low-dose combination with cytarabine and etoposide was performed. The result was that the blasts disappeared, his general condition improved and infection was reduced. Major side effects were absent; however, the blasts proliferated again after the treatment was discontinued. In conclusion, this combination may be useful treatment for myeloid blastic crises even if the patient is in poor condition. But the modification of the administration schedule requires some consideration.
Matano
S
S
Dept. of Internal Medicine, Tonami General Hospital, Japan.
Nakamura
S
S
Kobayashi
K
K
Kaya
H
H
Yoshida
T
T
Sugimoto
T
T
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001752:Blast Crisis; D002908:Chronic Disease; D003561:Cytarabine / Q000008:administration & dosage; D004334:Drug Administration Schedule; D005047:Etoposide / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D009196:Myeloproliferative Disorders / Q000188:drug therapy* / Q000473:pathology*
D003561:Cytarabine; D005047:Etoposide