Shibuya T, Teshima T, Harada M, Taniguchi S, Okamura T, Okamura S, Niho Y
First Department of Internal Medicine, Kyushu University Hospital, Fukuoka, Japan.
Leuk Res. 1990;14(2):161-7. doi: 10.1016/0145-2126(90)90045-b.
To study the therapeutic effect of low-dose aclarubicin (ACR), we carried out comparative treatment of 15 patients with myelodysplastic syndrome (MDS) and atypical leukemia using this drug. Complete remission (CR) was achieved in three patients with RAEB-t and one patient with AML, partial remission was obtained in one patient with RAEB and hematological improvement in one patient with refractory anemia (RA). Interestingly, prolonged CR for more than 26 months with persistent chromosomal abnormalities was observed in a case of AML, which progressed from RA. Myelosuppression caused by low-dose ACR was milder than that caused by low-dose Ara-C. Furthermore, in vitro studies indicated that ACR induced differentiation of bone marrow cells from one patient with MDS. From these observations, it is suggested that low-dose ACR may be an alternative to low-dose Ara-C for treatment of MDS, and that the in vivo effect of ACR may be mediated by the differentiation of abnormal hemopoietic clones.
为研究小剂量阿克拉霉素（ACR）的治疗效果，我们使用该药对15例骨髓增生异常综合征（MDS）和非典型白血病患者进行了对比治疗。3例RAEB-t患者和1例急性髓系白血病（AML）患者达到完全缓解（CR），1例RAEB患者获得部分缓解，1例难治性贫血（RA）患者血液学改善。有趣的是，1例由RA进展而来的AML患者出现了持续26个月以上的延长CR，且伴有持续的染色体异常。小剂量ACR引起的骨髓抑制比小剂量阿糖胞苷（Ara-C）引起的更轻。此外，体外研究表明，ACR可诱导1例MDS患者的骨髓细胞分化。基于这些观察结果，提示小剂量ACR可能是治疗MDS的小剂量Ara-C的替代药物，且ACR的体内作用可能由异常造血克隆的分化介导。
