Successful management of therapy-related chronic myelomonocytic leukemia with cytarabine, aclarubicin, and azacitidine following tegafur/gimeracil/oteracil.

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.