DISAPPEARANCE OF AML1-MTG8 TRANSCRIPT BY REVERSE-TRANSCRIPTASE POLYMERASE-CHAIN-REACTION IN A PATIENT IN REMISSION OF ACUTE MYELOID-LEUKEMIA (M2) AFTER LOW-DOSE CYTOSINE-ARABINOSIDE

It is well-known that low dose cytosine arabinoside (LDAC) has activit y in elderly patients with acute myeloid leukemia (AML). Several studi es have shown that AML patients with t(8;21) in long term complete rem ission (CR) following intensive chemotherapy or allogeneic bone marrow transplantation (BMT) still have persistence of AML1-MTG8 transcripts by reverse transcriptase polymerase chain reaction (RT-PCR) method. W e report here a patient who has no evidence of residual disease detect able by RT-PCR after LDAC. A 69-year-old patient did not obtain CR aft er two courses of intensive chemotherapy with behenoyl-ara-C, daunorub icin, ij-mercaptopurine and prednisolone. He received subcutaneous LDA C 10 mg every 12 h and granulocyte colony-stimulating factor (G-CSF) f or 29 days and achieved CR. He continued on a 21 to 28-day course of L DAC without G-CSF every 2 or 3 months and has remained well and in CR for 5 years without chimeric AML1-MTG8 transcript by RT-PCR. LDAC ther apy seems to be effective in eradicating the leukemic clone as post-in duction or maintenance therapy in this patient. This is the first case report of the disappearance of AML1-MTG8 transcript by RT-PCR in a pa tient with t(8;21) in long-term remission after LDAC. (C) 1998 Elsevie r Science Ltd. All rights reserved.