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Chemotherapy Related Leukemogenesis

  • Conference paper
Toxicology in the Use, Misuse, and Abuse of Food, Drugs, and Chemicals

Part of the book series: Archives of Toxicology ((TOXICOLOGY,volume 6))

Abstract

Administration of aggressive chemotherapy to patients with cancer has considerably improved their outlook for effective palliation or cure. However, a hitherto unappreciated complication consisting of a secondary malignancy, in particular acute leukemia, has emerged.

Prolonged therapy with alkylating agents and chemotherapy plus radiotherapy are associated with an increased risk of this complication. The disease evolves through a preleukemic phase of pancytopenia and sideroblastic refractory anemia. The median onset from the initiation of chemotherapy is about 5 years with an increasing incidence with time. Myelomonocytic, monocytic and erythroleukemia with atypical features and resistance to conventional therapy predominate. Hyploidy and aberrations involving chromosomes 5 and 7 are frequent.

Alkylating agents are carcinogenic in laboratory animals. Although the pathway to leukemogenesis in humans is unknown, a multistep evolution is envisaged. This involves: 1) initiation through induction of errors in DNA, 2) promotion related to stem cell replication following chemotherapy-induced aplasia and 3) propagation related to immunosuppression. It is possible that, as in myeloproliferative disorders, an underlying tendency for leukemia is present in patients with cancer. This may be accentuated by chemotherapy, and more frequently observed due to the longer survival of such patients. The crucial role of chemotherapy in leukemogenesis is evident from data accumulated in non-malignant conditions such as rheumatoid arthritis.

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Author information

Authors and Affiliations

  1. Institute of Hematology, Chaim Sheba Medical Center, Tel-Hashomer and Sackler School of Medicine, Tel-Aviv University, Israel, 52621

    Dr. Dina Meytes & B. Ramot

  2. Department Hematology, The Edith Wolfson Hospital, Holon, 58 100, Israel

    Dr. Dina Meytes

Authors
  1. Dr. Dina Meytes
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  2. B. Ramot
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Editor information

Editors and Affiliations

  1. Department of Pharmacology, Trinity College, University of Dublin, Dublin 2, Ireland

    Claire M. Chambers  & Philip L. Chambers  & 

  2. Sackler Faculty of Medicine, and Kupat Holim — General Federation of Labour, Institute for Occupational Health, Tel Aviv University, Tel Aviv, Israel

    S. Gitter

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© 1983 Springer-Verlag

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Meytes, D., Ramot, B. (1983). Chemotherapy Related Leukemogenesis. In: Chambers, C.M., Chambers, P.L., Gitter, S. (eds) Toxicology in the Use, Misuse, and Abuse of Food, Drugs, and Chemicals. Archives of Toxicology, vol 6. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-69083-9_2

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  • DOI: https://doi.org/10.1007/978-3-642-69083-9_2

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-12392-7

  • Online ISBN: 978-3-642-69083-9

  • eBook Packages: Springer Book Archive

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