Curtis R E, Hankey B F, Myers M H, Young J L
J Natl Cancer Inst. 1984 Mar;72(3):531-44.
The risk of leukemia associated with the first course of cancer treatment was evaluated in over 440,000 patients diagnosed during 1973-80 (average follow-up = 1.91 yr) from the National Cancer Institute's Surveillance, Epidemiology, and End Results Program. Although the reporting of the first course of therapy probably was incomplete, 34 acute nonlymphocytic leukemias (ANLL) developed compared with 7.6 expected among 70,674 patients known to receive initial chemotherapy [relative risk (RR) = 4.5, 95% confidence interval (Cl) = 3.1-6.3]. Significant ANLL excesses were observed following chemotherapy for breast cancer (RR = 8.1), ovarian cancer (RR = 22.2), and multiple myeloma (RR = 9.5). Patients initially treated with radiation (with no record of chemotherapy) also had a significantly increased ANLL risk; 45 leukemias occurred versus 17.9 expected (RR = 2.5, 95% Cl = 1.8-3.4). In this group, excess ANLL were found following irradiation for uterine corpus cancer (RR = 4.0). Kidney and renal pelvis cancer patients had a twofold leukemia risk (all types) that was unrelated to treatment (RR = 2.2).
来自美国国立癌症研究所监测、流行病学和最终结果计划的44万多名在1973 - 1980年期间被诊断出癌症的患者（平均随访时间 = 1.91年），其接受首个疗程癌症治疗后患白血病的风险得到了评估。尽管首个疗程治疗的报告可能并不完整，但在已知接受初始化疗的70674名患者中，出现了34例急性非淋巴细胞白血病（ANLL），而预期为7.6例[相对风险（RR）= 4.5，95%置信区间（Cl）= 3.1 - 6.3]。在乳腺癌（RR = 8.1）、卵巢癌（RR = 22.2）和多发性骨髓瘤（RR = 9.5）化疗后观察到显著的ANLL超额病例。最初接受放疗（无化疗记录）的患者ANLL风险也显著增加；发生了45例白血病，而预期为17.9例（RR = 2.5，95% Cl = 1.8 - 3.4）。在该组中，子宫体癌放疗后发现了超额的ANLL病例（RR = 4.0）。肾癌和肾盂癌患者患白血病的风险（所有类型）增加了两倍，且与治疗无关（RR = 2.2）。
