Acute Transformation of Chronic Myelogenous Leukemia November 9, 1994

Acute Transformation of Chronic Myelogenous Leukemia November 9, 1994

Acute transformation of chronic myelogenous leukemia usually has the following characteristics: high fever, bleeding, worsening anemia, increasing exhaustion; obvious sternal tenderness; peripheral blood showing more than 5% blast cells (from none to some should raise concern).

Treatment: In principle, chemotherapy should follow the acute non-lymphocytic leukemia protocol, with DA regimen being the first choice: cytarabine 50mg, twice daily, (days 1–5), DNR 30mg added to 5% glucose for intravenous drip (days 1–3). However, since the latter has strong clinical reactions, using cytarabine alone is also acceptable. Alternatively, 6-MP 50mg can be taken orally three times daily, with a treatment course lasting up to three months.

Recently, there’s been talk of using tripterygium glycosides at the same dosage as vincristine, but they can be administered for five consecutive days, similar to how 5-Fu and TSPA are used. Common medications for chronic myelogenous leukemia include busulfan and hydroxyurea, with the former at 2mg, three times daily, usable for several weeks, and the latter at 0.25g–0.5g, also three times daily, though some sources suggest only twice a week.