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作者对用细胞毒药物治疗的2,006例慢性炎症性风湿病和结缔组织病患者进行了回顾性调查,以确定这些患者发生急性白血病的数量,随访的时间为1～13年。在这些患者中有19例发生了急性白血病,主要是粒细胞性的,潜伏期为治疗开始后5.7±2.8年。白血病的发病率接近1%,大概还低于真正的发病率,因为某些病人中断随访和观察时间太短。这些病人的大多数都治疗1年以上,在治疗少于6个月或用苯丁酸氮芥少于1g 或用环磷酰胺少于50g 的病人中均未证实有白血病发生。两种烷化剂的危险性似乎是一样的。用硫唑嘌呤治疗的病人没有发生白血病者,但用
The authors conducted a retrospective review of 2,006 patients with chronic inflammatory rheumatic and connective tissue disease treated with cytotoxic drugs to determine the number of acute leukemias in these patients, ranging from 1 to 13 years. Nineteen of these patients developed acute leukemia, predominantly granulocytic, with an incubation period of 5.7 ± 2.8 years after initiation of treatment. The incidence of leukemia is close to 1%, probably lower than the true incidence, because some patients are discontinued and observation time is too short. Most of these patients were treated for more than 1 year, with no evidence of leukemia in patients treated for less than 6 months or less than 1 g chlorambucil or less than 50 g cyclophosphamide. The risk of two alkylating agents appears to be the same. Patients treated with azathioprine did not develop leukemia, but with