Acute tumor lysis in T-cell leukemia induced by amsacrine

The acridine orange derivative amsacrine (National Services Center No. 249992) was used to treat a patient with T-cell acute lymphoblastic leukemia (ALL). A 17-year-old boy had a tumor lysis syndrome after a single 200 mg/sq m dose of amsacrine. This was followed by a prolonged period of marrow hypoplasia leading to death from infection. Review of the literature and our own experience would suggest that T-cell ALL may be exquisitely sensitive to amsacrine.