Complete remission in prolymphocytic leukemia with 4-demethoxydaunorubicin and arabinosyl cytosine.

Prolymphocytic leukemia (PL) is a morphologically distinct disease generally characterized by unsatisfactory therapeutic response and brief survival. Aggressive chemotherapy protocols including doxorubicin (DX) have been successfully used as alternatives to treatments usually effective in chronic lymphocytic leukemia (CLL). A patient with typical PL, resistant to regimens containing DX, was treated with 4-demethoxydaunorubicin (4-dm DNR), a new anthracycline analog derived from daunorubicin (DNR). The therapeutic response was rapid and impressive; furthermore 4-dm DNR combined with arabinosyl cytosine (Ara-C) produced a complete remission which is unusual in PL.