Leukemia after Adjuvant Chemotherapy with Semustine (Methyl-CCNU) — Evidence of a Dose–Response Effect

Abstract
To the Editor: We reported1 a high risk of leukemia and preleukemia among 2067 patients given adjuvant semustine (methyl-CCNU) and fluorouracil in any of nine randomized clinical trials for gastrointestinal cancer (relative risk, 16; incidence rate, 2.4 cases per 1000 persons per year). Subsequently, we abstracted detailed information on the cumulative drug dose for all 19 patients in whom a leukemic disorder developed and for a 15 percent sample (n = 317) of all patients who received chemotherapy. (Since our last report, one additional acute nonlymphocytic leukemia occurred in an 84-year-old woman with colon cancer who received 293 mg of . . .

This publication has 5 references indexed in Scilit: