Rapid control of chronic granulocytic leukaemia

Abstract

Sixty patients with chronic granulocytic leukaemia (CGL), anaemia, hyperleukocytosis and hepatosplenomegaly were randomized into 3 treatment schedules consisting of (i) cyclophosphamide 000mg/m2 intravenously (IV) on day 1. (ii) cytosine arabinoside 100mg/m2 subcutaneously (sc) 12 hourly for days 1-5. (iii) combination of IV cyclophosphamide 600mg/m2 one day 1 and cytosine arabinoside lOOmg/m 12 hourly sc for days 1-5. Each cycle of treatment lasted 7 days. Patients on combined chemotherapy achieved laboratory and clinical remission within 28 days of treatment, while patients on single-agent chemotherapy of cytosine arabinoside or cyclophosphamide still had hyperleukocytosis and hepatosplenomegaly after 28 days of treatment. Six patients treated with cyclophosphamide only had thrombocytopenic bleeding, but no patient treated with either cytosine arabinoside only or a combination of cytosine arabinoside and cyclophosphamide bled. It is suggested that patients with CGL, anaemia, hyperleukocytosis and hepatosplenomegaly can be rapidly controlled with a combination of cytosine arabinoside and cyclophosphamide.