Two female patients, 42 and 30 years old, respectively, died of acute nonlymphocytic leukemia 43 and 38 months, respectively, after a subsequent treatment: chemotherapy for one and irradiation and chemotherapy for the other, following excision of a malignant glioma. At the time of death, both seemed to be in complete remission of their brain tumor. Both had been treated with procarbazine and nitrosoureas. The latter were responsible for severe myelosuppressive episodes and seem to have played an essential role in the induction of the leukemia. In one case, a myelodysplasia was observed before the onset of the AL and the diagnosis of refractory anemia with excess of blasts seemed warranted.
Secondary acute leukemias are rare in the evolution of malignant gliomas and the usefulness of subseqllent radiochemotherapy cannot be questioned at the present time. The risks involved in this therapy are minor when compared to the short-term fatal prognosis of this type of tumor.
Cancer 52:222-226, 1983.
H E PROGNOSIS of malignant gliomas is one of the T most severe. At present, intensive research is carried out on the treatment of these tumors.'-6 In recent years, the association of chemotherapy and irradiation6 following the largest possible surgical resection, has brought about some real progress in that direction. This type of treatment may also have very serious consequences. This report presents the cases of two patients who developed acute leukemia after treatment for an anaplastic astrocytoma and a glioblastoma, respectively. Both died of this hemopathy, while the recovery for their neurologic condition was quite satisfactory.
Case Reports
Cuse 1
In 1973, the diagnosis of left internal temporal astrocytoma was reached in the case of a 42-year-old woman without previous medical history, who presented several generalized convulsive episodes. With antiepileptic drugs, her neurologic condition remained stable for three years. In February 1976, she developed a right hemiparesis with aphasia. After confirmation of the increased volume of the tumor, the patient underwent