Acute myelogenous leukemia after exposure to strontium-89 for the treatment of adenocarcinoma of the prostate.
BACKGROUND
Strontium-89 is a pure Beta-emitting radioactive analogue of calcium that has been shown to be beneficial in the palliation of pain due to osseous metastases from adenocarcinoma of the prostate. The most significant reported toxicity is dose-related, reversible, myelosuppression characterized primarily by thrombocytopenia.


METHODS
A report of two patients in whom acute myelogenous leukemia (AML) developed after treatment with strontium-89 and a review of the literature are presented.


RESULTS
The two patients described in the current study developed AML 17 months and 26 months, respectively, after exposure to strontium-89 for the treatment of prostate carcinoma. To the authors' knowledge these patients represent the first two reported cases of AML after strontium-89 therapy for prostate carcinoma.


CONCLUSIONS
The results of the current study suggest the leukemogenic potential of strontium-89 treatment in humans. To the authors' knowledge, the current study represents the first report of AML after therapeutic exposure to strontium-89. As this agent is used more frequently (and earlier in the disease course) in patients with prostate carcinoma, an increased incidence of secondary AML complicating the clinical management of patients with prostate carcinoma may be observed. [See editorial on pages 497-9, this issue.]
Kossman
S E
SE
Division of Hematologic Oncology, Department of Medicine, Memorial Sloan-Kettering Cancer Center and Cornell University Medical College, New York, NY 10021, USA.
Weiss
M A
MA
D000230:Adenocarcinoma / Q000532:radiotherapy* / Q000556:secondary; D000368:Aged; D001610:Beta Particles / Q000009:adverse effects; D001859:Bone Neoplasms / Q000532:radiotherapy / Q000556:secondary; D004307:Dose-Response Relationship, Radiation; D017809:Fatal Outcome; D005500:Follow-Up Studies; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000209:etiology*; D007953:Leukemia, Radiation-Induced / Q000209:etiology*; D008297:Male; D016609:Neoplasms, Second Primary / Q000209:etiology*; D010166:Palliative Care; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D019275:Radiopharmaceuticals / Q000009:adverse effects* / Q000627:therapeutic use; D013326:Strontium Radioisotopes / Q000009:adverse effects* / Q000627:therapeutic use; D013921:Thrombocytopenia / Q000209:etiology
D019275:Radiopharmaceuticals; D013326:Strontium Radioisotopes