Azacitidine Treatment Following Intensive Chemotherapy with Daunorubicin and Cytarabin for Acute Transformation in Myelodysplastic/Myeloproliferative Neoplasms

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  • KAWAKAMI Toru
    Department of Hematology, NHO Matsumoto Medical Center
  • SAKAI Kaoko
    Division of Hematology, Department of Internal Medicine, Shinshu University School of Medicine
  • NISHINA Sayaka
    Division of Hematology, Department of Internal Medicine, Shinshu University School of Medicine
  • MIMURA Yuto
    Department of Hematology, NHO Matsumoto Medical Center
  • MIYAHIRA Takaaki
    Department of Hematology, NHO Matsumoto Medical Center
  • SENOO Yasushi
    Department of Hematology, NHO Matsumoto Medical Center
  • NAKAZAWA Hideyuki
    Department of Hematology, NHO Matsumoto Medical Center
  • KITANO Kiyoshi
    Department of Hematology, NHO Matsumoto Medical Center

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We report here a case of a 70-year-old male with myelodysplastic/myeloproliferative neoplasms (MDS/MPN) having hepatosplenomegaly, mild monocytosis, and normal karyotypes without JAK2 mutation. The patient developed an acute transformation and during the intensive therapy with daunorubicin and cytarabin, diffuse alveolar hemorrhage appeared due to disseminated intravascular coagulopathy. After induction, bone marrow blasts reduced to 5.1%, and the patient received two courses of azacitidine therapy. During these courses, blasts in the peripheral blood were not observed. Intensive chemotherapy consisting of daunorubicin and cytarabin followed by azacitidine therapy might be effective for acute transformation in MDS/MPN.

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