[Refractory anemia with excess myeloblast in transformation induced remission by combined oral administration of cytarabine ocfosfate and 6-mercaptopurine].

Abstract

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.

• Authors: S Fukumi, F Mizorogi, A Matsuo, H Sato, T Abe
• Journal: Gan to kagaku ryoho. Cancer & chemotherapy (Gan To Kagaku Ryoho) Vol. 22 Issue 7 Pg. 945-8 (Jun 1995) ISSN: 0385-0684 [Print] Japan
• PMID: 7794001 (Publication Type: Case Reports, Journal Article)

Chemical References

• Arabinonucleotides
• 1-arabinofuranosylcytosine-5'-stearylphosphate
• Mercaptopurine
• Cytidine Monophosphate

Topics

• Administration, Oral
• Anemia, Refractory, with Excess of Blasts (blood, drug therapy)
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Arabinonucleotides (administration & dosage)
• Cytidine Monophosphate (administration & dosage, analogs & derivatives)
• Female
• Humans
• Mercaptopurine (administration & dosage)
• Middle Aged
• Remission Induction