Methyl-glyoxal-bis-guanylhydrazone (methyl GAG) has induced complete hematologic remissions in patients with acute myelocytic leukemia. The hematologic pattern of remission was different from that observed for 6-mercaptopurine. Early lymphocytosis and increase in platelet counts occurred with both drugs. With methyl GAG the early granulation of immature cells and a relative rise in peripheral mature granulocytes developed. This could occur with persistent leukopenia and could precede the recovery of platelets. Repopulation of red cell precursors occurred at a similar rate with both drugs. Abnormal megaloblastoid erythropoiesis was seen in 11 of 14 patients treated with 6-MP; erythropoiesis was normoblastic in all patients treated with methyl GAG.

Recognition of the different patterns of remission characteristic of 6-MP and methyl GAG suggests different mechanisms of action for the two drugs. The criteria of impending remission observed with methyl GAG may make possible shortened administration of a toxic drug.

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