HANS W. GRÜNWALD, M.D.; FRED ROSNER, M.D.
To the editor: Strober and associates (1) report a randomized, double-blind trial in intractable rheumatoid arthritis (1) and an uncontrolled trial in intractable lupus nephritis (2). These authors state that "there is no increase in the risk of hematologic malignancies in patients given total lymphoid irradiation alone" and cite studies done in Stanford, Copenhagen, and Milan.
The risk of treatment-related leukemia is highest when radiotherapy is followed by combination or single-agent (usually alkylating agent) chemotherapy (3), but we have also pointed out the occurrence of acute myeloid leukemia in 20 patients who had only received radiotherapy for Hodgkin's disease. There
GRÜNWALD HW, ROSNER F. Rheumatoid Arthritis, Lupus Nephritus, and Risks of Lymphoid Irradiation. Ann Intern Med. ;103:155. doi: 10.7326/0003-4819-103-1-155_1
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Published: Ann Intern Med. 1985;103(1):155.
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