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Therapy-Related Acute Nonlymphocytic Leukemia with Monocytic Features and Rearrangement of Chromosome 11q

Russell DeVore, MD; James Whitlock, MD; John D. Hainsworth, MD; and David H. Johnson, MD
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Requests for Reprints: David H. Johnson, MD, Division of Oncology, 1956 The Vanderbilt Clinic, Nashville, TN 37232-5536.

Current Author Addresses: Drs. DeVore, Whitlock, Hainsworth, and Johnson: Division of Oncology, Vanderbilt University, Nashville, TN 37232.

Ann Intern Med. 1989;110(9):740-742. doi:10.7326/0003-4819-110-9-740
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Acute nonlymphocytic leukemia has been increasingly recognized as a complication of cancer treatment. Therapy-related leukemia has commonly been reported (1) after treatment of lymphomas and solid tumors in which alkylating agents (in particular cyclophosphamide, chlorambucil, and melphalan) have been a major component of the patient's initial therapy. Newer agents such as cisplatin and etoposide are not commonly recognized as being leukemogenic. In one large cohort of patients with testicular cancer, no case of therapy-related leukemia was identified (2) although all patients received cisplatin-based chemotherapy. Therefore, when one of our patients with testicular cancer developed acute nonlymphocytic leukemia after chemotherapy with


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