Treatment of acute myeloid leukemia converted from myelodysplastic syndrome with ATC regimen in a patient with chromosome 8 abnormality

This study evaluated the efficacy of ATC regimen in the treatment of acute myeloid leukemia (AML) transforming from myelodysplastic syndrome (MDS) in a patient with chromosome 8 abnormality. ATC regimen was administered for 3 months in each course for a total of 14 courses, and thalidomide was administered at 100 mg qd for maintenance therapy. Bone marrow cell morphology showed CR; flow cytometry was done to detect CD13+, CD33+, and MPO+ cells and indicated MRD at 10(-4); karyotyping and FISH showed cytogenetic remission was achieved after 1 course treatment with ATC regimen, and chromosome 8 abnormality was absent; recurrence was not observed with the prolongation of treatment. Lymphocyte subtyping showed the function of T cells and NK cells was improved, peripheral blood granulocytes and red blood cells rapidly returned to normal, followed by recovery of platelets with the prolongation of treatment with ATC regimen. Clinical observation indicated the patient was tolerant to this therapy and there were no adverse effects. The recurrence free survival time was as long as 47 months. In conclusion, ATC regimen is effective in the therapy of MDS or leukemia of patients with chromosome 8 abnormality, which may be ascribed to the clearance of malignant cloning of abnormal chromosome 8 and improvement of cellular immunity. Patients are tolerant to this regimen and have little adverse effects. Thus, it is preferred for patients who are not willing to receive intense chemotherapy and have no chance of cell transplantation.