Acute leukemia following chemotherapy and radiation therapy--a report of 15 cases.
14 patients developed acute nonlymphocytic leukemia and 1 patient developed Burkitt's leukemia following longterm chemotherapy and/or radiotherapy for other disorders. The main primary disorders included multiple myeloma, Hodgkin's disease, non-Hodgkin's lymphoma and breast carcinoma. Acute leukemia developed earlier in patients treated by chemotherapy with or without radiotherapy than in patients treated by radiotherapy alone (63 months, range 24-132 months; 201 months, range 48 months to 30 years, respectively). 13 patients presented without organomegaly and 8 were pancytopenic. Abnormalities of myeloid and erythroid cell lines were observed in the majority of the patients. A high rate of acute erythroleukemia (5 out of 14) was found. Increased reticulin fibers were found in 3 patients. The leukemia was invariably refractory to treatment with a median survival of 4 months. The possible role of preexisting abnormal marrow structure in the development of therapy-related leukemia is discussed.
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001853:Bone Marrow / Q000473:pathology; D001943:Breast Neoplasms / Q000628:therapy; D003131:Combined Modality Therapy / Q000009:adverse effects; D005260:Female; D006801:Humans; D007938:Leukemia / Q000209:etiology* / Q000473:pathology; D004915:Leukemia, Erythroblastic, Acute / Q000209:etiology; D007945:Leukemia, Lymphoid / Q000209:etiology; D007953:Leukemia, Radiation-Induced; D008223:Lymphoma / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000628:therapy; D011878:Radiotherapy / Q000009:adverse effects*; D012189:Retrospective Studies
D000970:Antineoplastic Agents