The American Journal of Medicine
Volume 81, Issue 6 , Pages 962-968, December 1986

Acute nonlymphocytic leukemia after treatment of small cell lung cancer☆☆☆

Division of Medical Oncology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA

Received 5 November 1985; accepted 10 December 1985.

Abstract 

From 1977 to 1982, 377 patients with small cell lung cancer were treated at Vanderbilt University Medical Center. All patients received combination chemotherapy consisting of cyclophosphamide, doxorubicin, and vincristine (CAV) with or without methotrexate, etoposide, and/or hexamethylmelamine. Thoracic and/or prophylactic cranial irradiation was administered to 159 (42 percent) and 192 (51 percent) patients, respectively. Acute nonlymphocytic leukemia was observed in two patients at 22 and 81 months from the start of therapy. The relative risk of leukemia was 154 (95 percent confidence limit, 38 to 293). A Kaplan-Meier estimate of the cumulative probability of leukemia was 1.9 ± 1.4 percent seven years after the start of treatment. The relative risk of leukemia is significantly increased in this group of patients (p <0.0001). Acute nonlymphocytic leukemia is a long-term complication of small cell lung cancer therapy.

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☆ This work was supported in part by National Institutes of Health Grant CA-19429 and American Cancer Society Grant JFCF-714. Dr. Johnson is a junior faculty clinical fellow of the American Cancer Society.

☆☆ A continuing medical education quiz on this article (one hour of Category 1 credit) appears on page A105 of this issue.

PII: 0002-9343(86)90388-8

The American Journal of Medicine
Volume 81, Issue 6 , Pages 962-968, December 1986

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