Adamson R H, Seiber S M
Environ Health Perspect. 1981 Jun;39:93-103. doi: 10.1289/ehp.813993.
The human population may be exposed to potentially leukemogenic agents, either in the form of drugs and food additives or as environmental contaminants and pollutants. However, in spite of the large number and diversity of these chemicals, only a few have been implicated as human leukemogens. One such agent is benzene, a known bone marrow depressant. A number of case reports have associated chronic exposure to this agent with the development of acute leukemia, as have several epidemiologic surveys. Treatment with various antitumor agents, including procarbazine, melphalan, thio-TEPA, chlorambucil, and cyclophosphamide, has also been associated with the development of acute leukemia. In addition, chloramphenicol and phenylbutazone have been implicated as human leukemogens, but the association between exposure to these two agents and acute leukemia appears at present to be weaker than it is for benzene and antitumor agent exposure. Despite such associations between exposure to chemicals and acute leukemia, several important problems exist with regard to implicating specific agents in the development of this neoplasm in man, including the paucity of animal models for chemically induced leukemia, and the frequent necessity to rely on single case reports or clusters of cases in which chemical exposures are associated with acute leukemia. Future efforts should be directed at performing properly designed and well executed epidemiologic studies, and at developing new in vitro and in vivo models for the study of this neoplasm.
人类可能会接触到潜在的致白血病物质，这些物质可以是药物、食品添加剂的形式，也可以是环境污染物和污染物的形式。然而，尽管这些化学物质数量众多且种类各异，但只有少数几种被认为是人类白血病致癌物。其中一种物质是苯，一种已知的骨髓抑制剂。一些病例报告将长期接触这种物质与急性白血病的发生联系起来，一些流行病学调查也是如此。使用包括丙卡巴肼、美法仑、硫替派、苯丁酸氮芥和环磷酰胺在内的各种抗肿瘤药物进行治疗，也与急性白血病的发生有关。此外，氯霉素和保泰松也被认为是人类白血病致癌物，但目前看来，接触这两种物质与急性白血病之间的关联比接触苯和抗肿瘤药物的关联要弱。尽管接触化学物质与急性白血病之间存在这样的关联，但在确定特定物质与人类这种肿瘤发生之间的关系方面存在几个重要问题，包括化学诱导白血病的动物模型匮乏，以及经常需要依赖化学物质接触与急性白血病相关的单个病例报告或病例群。未来的努力应致力于开展设计合理、执行良好的流行病学研究，以及开发用于研究这种肿瘤的新的体外和体内模型。
