title: Multiple myeloma and acute leukemia associated with alkylating agents.
abstract: Rapidly fatal acute myelomonocytic leukemia developed in five patients with multiple myeloma who were treated with melphalan for 28 to 54 months. In each patient, multiple myeloma responded to therapy and progress was satisfactory until the development of acute leukemia. At postmortem examination, leukemic infiltration of organs was seen, and there was little or no evidence of myeloma. Consideration of these cases and a review of the literature suggest that these circumstances represent the development of acute myelomonocytic leukemia rather than plasma cell leukemia; there also appears to be an increased incidence of acute leukemia in multiple myeloma, probably related to the alkylating agent.
mesh_terms: D000208:Acute Disease; D000368:Aged; D001853:Bone Marrow / Q000648:ultrastructure; D001854:Bone Marrow Cells; D001856:Bone Marrow Examination; D001859:Bone Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007951:Leukemia, Myeloid / Q000139:chemically induced* / Q000175:diagnosis; D007952:Leukemia, Plasma Cell / Q000175:diagnosis; D007958:Leukocyte Count; D008297:Male; D008558:Melphalan / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D008854:Microscopy, Electron; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000532:radiotherapy; D010950:Plasma Cells / Q000648:ultrastructure; D011241:Prednisone / Q000627:therapeutic use; D013739:Testosterone / Q000627:therapeutic use; D013997:Time Factors
chemical_list: D006454:Hemoglobins; D013739:Testosterone; D008558:Melphalan; D011241:Prednisone