Kapadia S B, Krause J R, Ellis L D, Pan S F, Wald N
Cancer. 1980 Mar 15;45(6):1315-21. doi: 10.1002/1097-0142(19800315)45:6<1315::aid-cncr2820450608>3.0.co;2-f.
Twenty individuals developed acute non-lymphocytic leukemia (ANLL) following long-term chemotherapy for other disorders. The primary disorders included non-Hodgkin's lymphoma (five), Hodgkin's disease (five), carcinoma (four), multiple myeloma (three), chronic leukemia (two), and rheumatoid arthritis. Leukemia developed from 11-132 months (mean approximately 60 months) following institution of chemotherapy and all cases have occurred since 1974. Pre-leukemic cytopenias were present in 15 individuals. Fifteen of the 20 patients had chromosome analyses and 14 were abnormal. The leukemia was invariably refractory to chemotherapy with a median survival of only two months. Of the patients autopsied, only one individual had any evidence of the primary malignancy. This study illustrates the need for surveillance for secondary ANLL following long-term chemotherapy with/without radiotherapy. Duration of optimal chemotherapy for the primary disease must be determined by control trials and weighed against the risk of developing a secondary leukemia.
20名个体在因其他疾病接受长期化疗后患上了急性非淋巴细胞白血病（ANLL）。原发性疾病包括非霍奇金淋巴瘤（5例）、霍奇金病（5例）、癌症（4例）、多发性骨髓瘤（3例）、慢性白血病（2例）和类风湿性关节炎。白血病在化疗开始后11至132个月（平均约60个月）发生，且所有病例均发生于1974年以后。15名个体存在白血病前期血细胞减少。20例患者中有15例进行了染色体分析，其中14例异常。这些白血病对化疗始终耐药，中位生存期仅为两个月。在接受尸检的患者中，只有1例有原发性恶性肿瘤的任何证据。本研究表明，在长期化疗伴或不伴放疗后，需要对继发性ANLL进行监测。原发性疾病的最佳化疗持续时间必须通过对照试验确定，并权衡发生继发性白血病的风险。
