| Successful induction of remissions in
adults with acute non lymphatic leukemia (ANLL) requires the use of
high dose aggressive chemotherapy which is not well tolerated by older
adults and few remissions are obtained in patients with ANLL secondary
to refractory anemia and other disorders (Moloney and Rosenthal, to
be published) For years investigators have attempted to discover methods
of producing remissions by inducing leukemic cells to differentiate
and recently Sachs ( 1978) has pointed out that a number of agents
were capable of inducing maturation in leukemic mouse myeloblasts.
Among the chemical compounds investigated was cytosine arabinoside
(Ara-C) an antimetabolite extensively used in high dosage for treatment
of ANLL Based on these experimental findings Baccarani and Tura (1979)
treated a patient with refractory anemia and excess myeloblasts in
the marrow with a short course of low dose Ara-C and obtained an excellent
clinical and hematological improvement with partial bone marrow remission,
Encouraged by this report we have treated two patients with early
ANIL and seven patients with RDA-ANLL with low dose Ara-C, Observations
on these cases and preliminary findings on the effect of low dose
Ara-C on leukemic cells cultured in diffusion chambers are presented
in this paper. |