Low-dose cytosine arabinoside in acute non-lymphoblastic leukemia

Eighteen previously untreated patients with acute non-lymphoblastic leukemia (ANLL) were treated with cytosine arabinoside (Ara-C) in low doses (10 mg/m2 every 12 hours) subcutaneously for 3 weeks. Complete remission (CR) was achieved in four patients (22.2%), and myelosuppression was observed in nearly all of them. Thrombocytopenia (20 X 10(3)/microliters) was pronounced in the third week of treatment and six patients (33.3%) needed platelet support. Contrary to earlier claims, our experience suggests that treatment with low-dose Ara-C is associated with significant cytopenias. Ara-C does not obviate the need for intensive supportive care and CR rates are no longer better. Low-dose Ara-C does not seem to be a choice in previously untreated ANLL patients who otherwise have a high probability of achieving a CR with standard multidrug chemotherapy protocols.