Toh B T, Gregory S A, Knospe W H
Department of Medicine, Rush Medical College, Chicago, IL 60612.
Am J Hematol. 1988 May;28(1):58-60. doi: 10.1002/ajh.2830280113.
Transformation to acute leukemia (AL) is known to occur in polycythemia vera (PV) and essential thrombocythemia (ET). Myelosuppressive therapy with agents such as 32P and alkylating agents increase this risk in both disorders. The alkylating agent, uracil mustard (UM), which is an effective agent for controlling thrombocytosis, has not been reported to be leukemogenic. We have treated 29 patients with UM (9 treated continuously and 20 treated intermittently): II with PV, 16 with ET, and 2 with myelofibrosis (MF). Three patients developed AL, two after continuous therapy. These two patients with PV had received the fourth highest and highest total dose of UM, and their duration of treatment was the third and fourth longest among the nine patients treated continuously, respectively. One out of 20 patients treated intermittently with UM developed AL. This patient (3) with ET had received the highest total dose of UM, and her duration of treatment was the longest among the 20 patients treated intermittently.
已知真性红细胞增多症（PV）和原发性血小板增多症（ET）会转化为急性白血病（AL）。使用如32P和烷化剂等药物进行骨髓抑制治疗会增加这两种疾病的这种风险。烷化剂尿嘧啶氮芥（UM）是控制血小板增多症的有效药物，尚未有其致白血病的报道。我们用UM治疗了29例患者（9例持续治疗，20例间歇治疗）：2例PV患者，16例ET患者，2例骨髓纤维化（MF）患者。3例患者发生了AL，2例在持续治疗后发生。这2例PV患者接受的UM总剂量分别为第四高和最高，且他们的治疗持续时间在9例持续治疗的患者中分别排第三和第四长。20例接受UM间歇治疗的患者中有1例发生了AL。该ET患者（3号）接受的UM总剂量最高，且她的治疗持续时间在20例间歇治疗的患者中最长。
