Therapy‐induced preleukaemia in patients treated for Hodgkin's lymphoma: clinical and therapeutic relevance of sequential chromosome banding studies

Abstract

Between Jan. 1978 and Dec. 1982 successful sequential chromosome analyses were carried out on bone marrow cells of 5 patients previously treated for Hodgkin''s lymphoma (HL) presenting unexplained cytopenia or pancytopenia during follow-up. All patients had concurrent morphological examination of bone marrow specimens showing signs of dysplasia and/or hypoplasia, without leukemic infiltrate. Six other patients treated for HL who had normal hematological parameters served as controls. All the patients with unexplained cytopenias had clonal chromosome abnormalities; monosomy for chromosome No. 5 was the most frequent. No abnormalities were detected in the control group. Two patients have evolved to resistant leukemia, one died of sepsis before leukaemic conversion while severely neutropenic and 2 are in full marrow and cytogenetic recovery after aggressive anti-leukemic treatment in the pre-leukemic phase. Cytogenetic studies may be of crucial value in detecting therapy-induced preleukemia (t-PL) at an early stage of its evolution and in planning appropriate therapy before the establishment of overt leukemia.