Prolonged survival in patients with treatment-related leukemia

We summarize the findings in 2 patients with treatment-related acute leukemia, who have had prolonged disease-free survival (62 and 84 months, respectively). The 1st patient developed acute myelogenous leukemia after receiving whole pelvic radiation and chlorambucil daily for 7 yr, as treatment for Stage III ovarian carcinoma; and the 2nd patient received cyclophosphamide, doxorubicin, vincristine and prednisone for Stage IV non-Hodgkin's lymphoma and subsequently developed acute monoblastic leukemia. The most remarkable finding is the unusually prolonged survival of both these patients with what is generally considered to be a very poor prognostic type of leukemia (mean survival less than 6 months). One predictive factor may have been the normal chromosomes in 1 patient. Since prolonged survival is possible in treatment-related leukemia, it is recommended that aggressive induction chemotherapy be at least considered for all such patients.