Abstract
Nine adult patients with metachronous secondary acute leukemia, who had been treated at the National Cancer Center Hospital, were analyzed from a clinical hematology viewpoint.
The findings were as follows: 1) The interval period from primary cancer to secondary acute leukemia was 1 year and 4 months to 10 years and 6 months, and the median interval time was 5 years and 1 month. 2) The 9 cases consisted of 2 cases of uterine cancer, and one case each of skin cancer, tongue cancer, laryngeal cancer, gastric cancer, thyroid cancer, parotid cancer and seminoma. 3) They were divided into four groups by therapy used for the primary cancers. Four cases were treated with surgery alone and one case was treated with radiation alone. Three cases were treated with a combination of surgery and radiation. A further case was treated with a combination of surgery, radiation and chemotherapy. 4) The nine cases with secondary acute leukemia were divided into the following two groups by the initial treatment and the subtype of French-American-British group classification. One group was the surgical group. The other was the radiation ± surgery/chemotherapy group. The former group consisted of two L2 cases, one M2 case and one M3 case. The latter, including two cases who developed acute leukemia after myelodysplastic syndrome, consisted of three M2 cases, one M4 case and one M5 case. 5) In the secondary acute leukemia, the response rates were compared between the surgical group and the radiation ± surgery/chemotherapy group. Complete or partial remission rate was 50% or 50% in the former, and 20% or 0% in the latter, respectively. 6) The median survival time was 1 year and 1 month in the former and 2 months in the latter, respectively. 7) The main causes of death were pneumonia and/or cerebral hemorrhage.
