Baccarani M, Zaccaria A, Bandini G, Cavazzini G, Fanin R, Tura S
Leuk Res. 1983;7(4):539-45. doi: 10.1016/0145-2126(83)90048-6.
Several agents, including arabinosyl cytosine (ARA-C) at a low concentration, can induce leukemic myeloblasts to mature to a variable extent. The therapeutic implications of this observation are worth investigating. A few case-reports have shown that low dose ARA-C can be useful for treatment of the myelodysplastic syndromes (MDS) and of acute myeloid leukemia (AML). However, no information is available yet on the proportion of patients who can be expected to respond. We treated by low dose ARA-C (20-30 mg/sqm/day i.v. or i.m. for 7-10 days) 20 consecutive patients. A complete remission of 5 months was obtained in one of nine cases of subacute myeloid leukemia (SAML). A partial remission (complete normalization of blood counts with a slight excess of marrow blast cells) was obtained twice in one of 11 cases of MDS. An increase of Hb level (more than 11.5 g/dl) was obtained and maintained for 12 months in a case of MDS. A short-lasting increase of granulocyte count was obtained in another two cases of MDS and SAML respectively. It is suggested that low dose ARA-C can advantageously modify the proliferation to maturation imbalance of leukemic cells by slowing down cell proliferation rate. However, the proportion of patients who respond is probably low. This treatment is at a very early experimental stage and should be probably limited to selected cases of MDS and subacute or acute myeloid leukemia.
包括低浓度阿糖胞苷（ARA - C）在内的几种药物可诱导白血病成髓细胞不同程度地成熟。这一观察结果的治疗意义值得研究。一些病例报告表明，低剂量的ARA - C可用于治疗骨髓增生异常综合征（MDS）和急性髓系白血病（AML）。然而，目前尚无关于预期有反应患者比例的信息。我们用低剂量ARA - C（20 - 30mg/m²/天，静脉注射或肌肉注射，共7 - 10天）连续治疗了20例患者。9例亚急性髓系白血病（SAML）中有1例获得了5个月的完全缓解。11例MDS中有1例两次获得部分缓解（血细胞计数完全正常，但骨髓原始细胞略有增多）。1例MDS患者的血红蛋白水平升高（超过11.5g/dl）并维持了12个月。另外2例MDS和SAML患者分别出现了粒细胞计数的短暂升高。提示低剂量ARA - C可通过减慢细胞增殖速率，有利地改变白血病细胞增殖与成熟的失衡。然而，有反应的患者比例可能较低。这种治疗尚处于非常早期的实验阶段，可能应仅限于MDS以及亚急性或急性髓系白血病的特定病例。
