Brenner B, Carter A, Sharon R, Tatarsky I
Oncology. 1984;41(2):83-7. doi: 10.1159/000225798.
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.
14例患者在因其他疾病接受长期化疗和/或放疗后发生急性非淋巴细胞白血病，1例患者发生伯基特白血病。主要原发疾病包括多发性骨髓瘤、霍奇金病、非霍奇金淋巴瘤和乳腺癌。接受化疗加或不加放疗的患者比仅接受放疗的患者急性白血病发病更早（分别为63个月，范围24 - 132个月；201个月，范围48个月至30年）。13例患者就诊时无脏器肿大，8例全血细胞减少。大多数患者观察到髓系和红系细胞系异常。发现急性红白血病发生率很高（14例中有5例）。3例患者发现网硬蛋白纤维增加。白血病对治疗始终难治，中位生存期为4个月。讨论了预先存在的异常骨髓结构在治疗相关白血病发生中的可能作用。
