Melphalan may be a more potent leukemogen than cyclophosphamide

M. H. Greene, E. L. Harris, D. M. Gershenson, G. D. Malkasian, L. J. Melton, A. J. Dembo, J. M. Bennett, W. C. Moloney, J. D. Boice

Research output: Contribution to journalArticle

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Abstract

We have evaluated the relation between alkylating agents and leukemic disorders in 3363 1-year survivors of ovarian cancer who were treated in five randomized clinical trials and at two large medical centers. Overall, 28 patients developed acute nonlymphocytic leukemia (expected, 1.2) and 7 developed preleukemia. A 93-fold increased risk for acute nonlymphocytic leukemia was seen in 1794 women treated with chemotherapy; the incidence of leukemic disorders was 7.7/1000 women per year. Risk was highest 5 to 6 years after the first treatment and appeared to decrease thereafter. The use of radiation therapy did not affect risk. The 10-year cumulative risk (mean ± SE) of acquiring a leukemic disorder was 8.5% ± 1.6% after treatment with any alkylating agent, 11.2% ± 2.6% after treatment with melphalan, and 5.4% ± 3.2% after cyclophosphamide treatment. A dose-response relationship was apparent in 605 women receiving melphalan and suggested in 333 women receiving cyclophosphamide. Women receiving melphalan were two to three times as likely to develop leukemic disorders than were women receiving cyclophosphamide. These data indicate that choice of chemotherapeutic agent and drug dosage may influence significantly the risk for long-term adverse effects of cancer therapy.

Original languageEnglish (US)
Pages (from-to)360-367
Number of pages8
JournalAnnals of Internal Medicine
Volume105
Issue number3
StatePublished - 1986
Externally publishedYes

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Melphalan
Cyclophosphamide
Alkylating Agents
Acute Myeloid Leukemia
Preleukemia
Therapeutics
Ovarian Neoplasms
Survivors
Radiotherapy
Randomized Controlled Trials
Drug Therapy
Incidence
Pharmaceutical Preparations
Neoplasms

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Greene, M. H., Harris, E. L., Gershenson, D. M., Malkasian, G. D., Melton, L. J., Dembo, A. J., ... Boice, J. D. (1986). Melphalan may be a more potent leukemogen than cyclophosphamide. Annals of Internal Medicine, 105(3), 360-367.

Melphalan may be a more potent leukemogen than cyclophosphamide. / Greene, M. H.; Harris, E. L.; Gershenson, D. M.; Malkasian, G. D.; Melton, L. J.; Dembo, A. J.; Bennett, J. M.; Moloney, W. C.; Boice, J. D.

In: Annals of Internal Medicine, Vol. 105, No. 3, 1986, p. 360-367.

Research output: Contribution to journalArticle

Greene, MH, Harris, EL, Gershenson, DM, Malkasian, GD, Melton, LJ, Dembo, AJ, Bennett, JM, Moloney, WC & Boice, JD 1986, 'Melphalan may be a more potent leukemogen than cyclophosphamide', Annals of Internal Medicine, vol. 105, no. 3, pp. 360-367.
Greene MH, Harris EL, Gershenson DM, Malkasian GD, Melton LJ, Dembo AJ et al. Melphalan may be a more potent leukemogen than cyclophosphamide. Annals of Internal Medicine. 1986;105(3):360-367.
Greene, M. H. ; Harris, E. L. ; Gershenson, D. M. ; Malkasian, G. D. ; Melton, L. J. ; Dembo, A. J. ; Bennett, J. M. ; Moloney, W. C. ; Boice, J. D. / Melphalan may be a more potent leukemogen than cyclophosphamide. In: Annals of Internal Medicine. 1986 ; Vol. 105, No. 3. pp. 360-367.
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