Cytogenetic studies of bone marrow in breast cancer patients after adjuvant chemotherapy

Abstract

Bone marrow chromosome studies were done on three patients who developed acute nonlymphocytic leukemia 5 to 19 months after completion of adjuvant chemotherapy for breast cancer, and on 17 breast cancer patients without hematologic disease 2 to 30 months after similar adjuvant therapy. Clones of cells with multiple cytogenetic abnormalities were demonstrated in two of the three leukemic patients. No chromosomally abnormal clones or evidence of increased chromosome damage was found in the 17 nonleukemic individuals. Although leukemias induced by chemotherapy, and particularly by alkylating agents, typically show multiple cytogenetic alterations, it appears that patients recently exposed to these agents, but without obvious hematopoietic disorders, do not have a high frequency of aberrant marrow clones. Additional approaches may be needed for early identification of patients at increased risk for chemotherapy-induced leukemia.

Specific chromosomal mutagenesis observed in stimulated lymphocytes from patients with S‐ANLL

“…Intensive chemotherapy and/or radiotherapy for malignant hematopoietic disorders, solid tumors, and even non-malignant diseases may be complicated by the development of secondary acute non-lymphocytic leukemia (S-ANLL) (De Bock and Peetermans, 1977;Coltman and Dixon, 1982;Greene et al, 1982;Boice et al, 1983;Chak et al, 1984). Among chemotherapeutic drugs, alkylating agents appear to be the most leukemogenic (Einhorn, 1978;Nowell et al, 1981;Greene et al, 1982;Tucker et al, 1987).…”

Chromosomal aberrations in lymphocytes of patients treated with melphalan

“…It appears that alkylating agents such as melphalan are particularly likely to induce ANLL (Reimer er al., 1977;Einhorn, 1978;Nowell et al, 1981), but only a few studies on the chromosomal lesions they induce in vitro as well as in vivo have been published so far (Schinzel and Schmid, 1976;Meyne et al. 1979;Honeycombe, 1978;Reeves and Margoles, 1974;Kaina, 1977;KuEerova and Polivkova, 1976;Morad and El Zawahri, 1977;Lawler et al, 1982;Gebhart et al, 1980;Lambert et al, 1984;Bochkov et al, 1986).…”