Explore the vast range of titles available.

A 55‐year‐old man was diagnosed with therapy‐related chronic myelomonocytic leukemia (t‐CMML) after exposure to tegafur/gimeracil/oteracil. Although he was refractory to hydroxyurea and low‐dose cytarabine, combination therapy with cytarabine, aclarubicin and azacitidine (CA‐AZA) provided good disease control, and he underwent allogeneic stem cell transplantation. This report has two key massages. First, tegafur/gimeracil/oteracil may have a potential risk of developing t‐CMML. Second, CA‐AZA therapy may be considered as a therapeutic option for patients with t‐CMML. Although neither hydroxyurea (HU) nor low‐dose cytarabine (LDAraC) was able to control the disease course, combination therapy with cytarabine, aclarubicin, and azacytidine (CA‐AZA) successfully reduced the number of white blood cells (WBC) including monocytes.

The prognosis of adult T-cell leukemia/lymphoma (ATL) with primary central nervous system (CNS) involvement has been unclear since the advent of new therapies. Recently, we have shown that flow cytometric CD7/CADM1 analysis of CD4 + cells (HAS-Flow) is useful to detect ATL cells that are not morphologically diagnosed as ATL cells. We investigated the role of CNS involvement in ATL using cytology and HAS-Flow by analyzing cerebrospinal fluid (CSF) from 73 aggressive ATL cases. Based on the findings in CSF, the study subjects were classified into CNS + (cytologically malignant, n  = 18), CNS- (cytologically non-malignant and ATL cell population negative in HAS-Flow, n  = 44), and CNS-Micro (cytologically non-malignant and ATL cell population positive in HAS-Flow, n  = 11) groups. As expected, the CNS + group had a shorter overall survival than the CNS- groups ( P  < 0.001). However, the CNS-Micro group showed no adverse impact on overall survival compared to the CNS- group ( P  = 0.506), even without additional CNS-targeted treatments. HAS-Flow also demonstrated clinical utility in the diagnosis of CSF lesions in ATL patients with cerebral white matter lesions and in the detection of ATL cells on post-treatment CSF examination in patients with CNS involvement. Our study demonstrates that ATL with CNS involvement have a poor prognosis and that CSF HAS-Flow is useful to assist in the diagnosis of suspected CNS involvement and to detect ATL cells with high sensitivity after treatment.