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作者回顾既往9年中476例接受马法兰和强的松间歇治疗的多发性骨髓瘤。缓解后,除34例未继续化疗外,其余病例均采用马法兰—强的松间歇治疗或卡氮芥—强的松联合治疗直至复发或死亡。结果6例发生了急性白血病,5例发生了铁粒幼细胞性贫血。比同年龄正常人预计的发病率至少约高100倍。此类第二种骨髓疾患出现在化疗3～68个月,中数38个月。最早的实验室异常系血红蛋白从缓解时的>10克％降至<8克％,7例并有血小板计数下降,低于8万/立方毫米。急性白血病为粒或单核细胞型,对化疗均无反应。 6例作了染色体研究,显示有显著异常,包括亚
The authors reviewed 476 patients with multiple myeloma treated intermittently with melphalan and prednisone in the previous nine years. After remission, except for 34 cases who did not continue chemotherapy, the remaining cases were treated with melphalan - prednisone intermittently or combined with carmustine - prednisone until recurrence or death. Results Six cases had acute leukemia and five had erythroid cell anemia. It is at least about 100 times more than the expected rate of normal people of the same age. Such second bone marrow disease appears in 3 to 68 months of chemotherapy, the median 38 months. The earliest laboratory abnormalities hemoglobin decreased from> 10 g% to <8 g% at remission, and 7 patients had a decrease in platelet count of less than 80,000 / mm3. Acute leukemia is a monocytic or monocytic type that has no response to chemotherapy. Chromosome studies were performed in 6 cases and showed significant abnormalities including subtypes