Krulik M, Grolleau J Y, Audebert A A, Mougeot-Martin M, Harousseau J L, Hervouet D, Debray J
Sem Hop. 1977 Dec 9;53(42):2425-35.
The authors report five cases of acute granular leukemia which complicated the course of multiple myeloma treated by chemotherapy. They then review the literature, and discuss 30 cases which they found. The important point clinically is the long duration of the course (average 56 months) in multiple myeloma complicated by acute granular leukemia. Usually chemotherapy permitted a good quality remission and when the leukemia develops there is no longer any trace of myeloma. The mechanisms of onset of this type of leukemia during myeloma are discussed. They are probably complex and various but there is no doubt concerning the responsability of chemotherapy and in particular alkylating agents.
作者报告了5例急性粒细胞白血病病例，这些病例使接受化疗的多发性骨髓瘤病程复杂化。然后他们回顾了文献，并讨论了他们找到的30个病例。临床上的要点是，多发性骨髓瘤合并急性粒细胞白血病时病程较长（平均56个月）。通常化疗可实现良好的缓解质量，而当白血病发生时，骨髓瘤已毫无踪迹。文中讨论了这种白血病在骨髓瘤病程中发生的机制。其机制可能复杂多样，但化疗尤其是烷化剂的作用无疑是存在的。
