Acute leukemia in a patient cured of diffuse histiocytic lymphoma.

A patient is described who, after completing treatment for diffuse histiocytic lymphoma, remained disease-free for 7 years (presumably cured), then developed acute nonlymphocytic leukemia (ANLL) after a brief preleukemic phase. Marrow cytogenetic analysis at the onset of frank leukemia revealed loss of chromosomes 5 and 7, which is consistent with secondary leukemia. She received only chemotherapy for her lymphoma, including high doses of an alkylating agent and a nitrosourea, which may have contributed to the development of the leukemia. This case report suggests that secondary ANLL may complicate the course of some long-term disease-free survivors of diffuse histiocytic lymphoma.