Successful low-dose cytosine arabinoside treatment in a patient with acuteleukemia from idiopathic myelofibrosis

We report a 63-year-old male with acute leukemia developed from idiopathic myelofibrosis. Cytogenetic analysis revealed chromosomal abnormalities; 46, XY,t(3;21)(q21;q22) del(20q). Intensive chemotherapies [combination of adri amycine/vincristine/prednisolone, or idarubicine/cytosine arabinoside (Ara- C)] were unsuccessful. The patient was then treated with continuous intrave nous low-dose Bra-C because of his poor physical condition and showed marke d hematological improvement. Leukemic cells disappeared from the peripheral blood and the segmented neutrophil count recovered. The dysplastic;morphol ogy observed in the segmented neutrophils suggests that the recovery of the neutrophils has resulted mainly from the differentiation activity of Ara-C .