Travis L B, Li C Y, Zhang Z N, Li D G, Yin S N, Chow W H, Li G L, Dosemeci M, Blot W, Fraumeni J F
Epidemiology and Biostatistics Program, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20892.
Leuk Lymphoma. 1994 Jun;14(1-2):91-102. doi: 10.3109/10428199409049654.
Although the relationship between benzene and acute nonlymphocytic leukemia (ANLL) is well established, most of the analytic cohort investigations examining the relationship between benzene and hematologic neoplasms have evaluated only death certificates to validate diagnoses. In a follow-up study of 74,828 benzene-exposed and 35,805 non-exposed workers in China, pathology reports, medical records, and/or histopathologic material were reviewed for all patients with hematopoietic malignancies to ensure correct classification and to provide clinicopathologic descriptions. Eighty-two patients with hematopoietic neoplasms and related disorders were identified among benzene-exposed workers, including 32 cases of acute leukemia, 7--myelodysplastic syndrome (MDS), 9--chronic granulocytic leukemia (CGL), 20--malignant lymphoma or related disorder (ML), 9--aplastic anemia, and 5 others. Among the comparison group, 13 hematologic malignancies were observed, including 6 patients with acute leukemia, 2--CGL, 3--ML, and 2 others. The hematopathologic characteristics of the benzene-exposed ANLL cases resembled those following chemotherapy or radiotherapy. ANLL in workers exposed to benzene may represent a distinct clinicopathologic entity, with characteristics similar to treatment-related ANLL, including a preceding preleukemic phase in some patients. Results in our series, one of the largest to data, also indicate that a greater diversity of hematologic neoplasms is evident among benzene-exposed workers than previously described.
尽管苯与急性非淋巴细胞白血病（ANLL）之间的关系已得到充分证实，但大多数研究苯与血液系统肿瘤关系的分析队列研究仅通过死亡证明来验证诊断。在中国一项对74828名接触苯的工人和35805名未接触苯的工人的随访研究中，对所有造血系统恶性肿瘤患者的病理报告、病历和/或组织病理学材料进行了审查，以确保正确分类并提供临床病理描述。在接触苯的工人中确定了82例造血系统肿瘤及相关疾病患者，包括32例急性白血病、7例骨髓增生异常综合征（MDS）、9例慢性粒细胞白血病（CGL）、20例恶性淋巴瘤或相关疾病（ML）、9例再生障碍性贫血和5例其他疾病。在对照组中，观察到13例血液系统恶性肿瘤，包括6例急性白血病、2例CGL、3例ML和2例其他疾病。接触苯的ANLL病例的血液病理学特征与化疗或放疗后的特征相似。接触苯的工人中的ANLL可能代表一种独特的临床病理实体，其特征与治疗相关的ANLL相似，包括一些患者有白血病前期。本系列研究结果是目前最大规模的研究之一，也表明接触苯的工人中血液系统肿瘤的多样性比以前描述的更为明显。
