Acute Myelomonocytic Leukemia in a Patient with Hodgkin’s Disease

Abstract

A case report of a patient that developed acute myelomonocytic leukemia after Hodgkin’s disease, treated with total nodal irradiation, is presented. The relationships between Hodgkin’s disease and leukemia and in particular radiation leukemoge nesis are discussed and it is concluded that treatment with ionizing radiation is the single most important etiological factor.

Simultaneous Occurrence of Myeloma and Hodgkin’s Disease

“…[2] observed a 3.5-fold increase in the risk of developing a second malignancy in all patients, with the greatest risk (29-fold) in a group of 35 patients who had received both intensive radiotherapy and intensive chemo therapy. The spectrum of second malignancies in Hodgkin's patients is broad [4,10,13], acute leukemia having been particularly emphasized [5,II,12,14], The increased incidence of second neoplasms in Hodgkin's patients has been attributed to the cellular immune deficiency associated with the disease as well as the immunosuppressive effects of radiotherapy and chemotherapy.…”

Myelodysplasia and leukaemia related to chemotherapy and/or radiotherapy-a haematological study of 13 cases. Value of macrocytosis as an early sign of bone marrow injury

“…Recently, acute myelogenous leukaemia secondary to treatment of various diseases has drawn the attention of many oncologists and haematologists (Videbaek 1973, Canellos et al 1975, Rosner 1976, Preisler & Lyman 1977, Auclerc et al 1978. Cases have been most often reported in multiple myeloma (Andersen & Videbaek 1970, Kyle et al 1970, Rosner & Grunwald 1974, Kyle et al 1975 Hodgkin's disease (Steinberg et al 1970, Zwaan & Speck 1973, Rosner & Grunwald 1975, Cadman et al 1977, Coleman et al 1977 breast cancer (Rosner et al 1978), ovarian carcinoma (Reimer et al 1977, Kapadia & Krause 1978 and in non-malignant diseases receiving immunosuppressive therapy (Silvergleid & Schrier 1974, Tulliez et al 1974, Tchernia et al 1976, Grunwald & Rosner 1979. Although some authors have reported a period of pancytopenia during the preleukaemic phase, (Weiden et al 1973, Kapadia & Krause 1978, only a few documented the haematological changes before the development of acute leukaemia.…”

Myeloma in a Case of Hodgkin’s Disease

“…In this regard, Hodgkin's disease is probably no exception and the occurr ence of second malignancies in this disease has now been the subject of a number of reports [1,2,4,6,9,10,[12][13][14], For example, the occurrence of leukaemia in Hodgkin's disease is now well documented [15]. Howev er, myeloma in established Hodgkin's disease seems to be rare, and we have been able to find only one previous report of this association, in which 2 patients with Hodgkin's disease treated with radiotherapy alone, developed typical myelomatosis [7].…”