Low dose cytosine arabinoside in the treatment of myeloid leukaemias and myelodysplastic syndromes

TWELVE patients were treated with low-dose cytosine arabinoside (15 mg/m²). Eight patients had acute myeloid leukaemia (AML), two had myelodysplastic syndromes (MDS) and two patients had myelofibrosis. Three patients with AML achieved a complete remission (CR), and one patient achieved CR following the addition of COAP (cyclophosphamide, vincristine, cytosine arabinoside, prednisone). Two patients with MDS achieved a CR, one patient requiring the addition of COAP. One of two patients with myelofibrosis showed a partial response to treatment. All patients required intensive platelet support but infections were few. Low-dose cytosine arabinoside should be considered as initial therapy in elderly patients with AML and MDS. Its role in myelofibrosis remains to be established.