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

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. Shinshu Med J 62 : 167―172, 2014 (Received for publication December 16,2013;accepted in revised form January 30,2014)