Erythrocyte mean corpuscular volume during cytotoxic therapy is a predictive parameter of secondary leukemia in Hodgkin's disease.
Mean corpuscular volume (MCV) evolution during cytotoxic therapy was studied in 32 patients with Hodgkin's disease (HD) who developed therapy-related acute nonlymphocytic leukemia (t-ANLL) and in 64 HD controls matched for age, therapy duration, and MOPP (mechlorethamine, vincristine, procarbazine, and prednisone) administration. Maximum MCV during therapy reached 108.3 +/- 8.2 fl in t-ANLL patients and 103.4 +/- 9.1 fl in the controls (P = 0.001). Maximum MCV increase was 26.7 +/- 8.3 fl in t-ANLL patients and 16.6 +/- 8.3 fl in the controls (P = 10(-9). The greatest 3-month increase observed during therapy was 14.8 +/- 6 fl in the t-ANLL patients and 10.1 +/- 4.8 fl in the controls (P = 0.0001). During initial MOPP therapy, the greatest 3-month increase reached 14.1 +/- 5.3 fl in t-ANLL patients and 9.8 +/- 4.5 fl in the controls (P = 0.01). The relative risk of developing t-ANLL was 9 for a MCV maximum increase over 24 fl during therapy, which was observed in 71% of the patients with t-ANLL and in only 22% of the controls. For the greatest 3-month MCV increase over 15 fl observed in 57% of the t-ANLL patients and in 17% of the controls, the relative risk reached 15. This suggests that there is at least one factor, independent from therapy, which predisposes to t-ANLL. MCV evolution during therapy appears useful in determining which HD patients have a high risk of developing t-ANLL.
de Gramont
A
A
Louvet
C
C
Krulik
M
M
Smadja
N
N
Donadio
D
D
Laporte
J P
JP
Brissaud
P
P
Delâge
J M
JM
Drolet
Y
Y
Rioux
E
E
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D004909:Erythrocyte Indices; D006689:Hodgkin Disease / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D007945:Leukemia, Lymphoid / Q000209:etiology*; D008433:Mathematics; D008466:Mechlorethamine / Q000627:therapeutic use; D011241:Prednisone / Q000627:therapeutic use; D011344:Procarbazine / Q000627:therapeutic use; D011379:Prognosis; D012306:Risk; D013997:Time Factors; D014750:Vincristine / Q000627:therapeutic use
D011344:Procarbazine; D008466:Mechlorethamine; D014750:Vincristine; D011241:Prednisone