Low-Dose Cytarabine: Persistence of a Clonal Abnormality during Complete Remission of Acute Nonlymphocytic Leukemia

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Abstract
To the Editor: Low-dose cytarabine is now recognized as an effective treatment in preleukemic syndromes1 and in some cases of acute nonlymphocytic leukemia.2 However, the mechanism of action is very controversial. Does it act, at least in part, through differentiation, as suggested by in vitro experiments3 and clinical observations of remissions achieved without major bone marrow hypoplasia?4 Or does it act only as a cytotoxic agent, as is supposed in conventional-dose regimens? Rare observations of the persistence of a marker of the leukemic clone during clinical remission are an argument to support the first of these hypotheses We describe the . . .