Acute myelocytic leukemia following prolonged streptozotocin therapy

A 69-year-old man with metastatic islet cell carcinoma was treated with streptozotocin and achieved excellent tumor regression. Sixty-seven grams of streptozotocin were given over 28 months. After completion of streptozotocin therapy, the patient had progressive leukopenia. Thirteen months after discontinuation of streptozotocin, acute myelocytic leukemia developed in the patient. He received aggressive antileukemia therapy but died without achieving complete remission. Streptozotocin should be added to the list of chemotherapeutic agents whose prolonged use in the management of a primary malignancy has been followed by the appearance of acute leukemia.