Acute leukemia developed in two patients who had been in remission for longer than two years after receiving intensive combination chemotherapy and radiotherapy for small-cell carcinoma of the lung. Both patients were first seen with pancytopenia and sideroblastic anemia with increased erythroblasts in the bone marrow. Chromosomal abnormalities were demonstrated in both cases. It is likely that the intensive combination therapy given to these patients caused transformation of bone marrow stem cells, resulting in acute leukemia.
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Markman et al. (1982) studied this question.
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