Erythrocyte Abnormalities Induced by Chemotherapy and Radiotherapy: Induction of Preleukaemic States?

Abstract

Increased incidence of acute leukaemia (AL) following exposure to ionizing radiation is well documented. AL has also been reported with increased frequency after chemotherapy for nonmalignant diseases. The effect of chemotherapy and/or radiotherapy on the following erythrocyte parameters: pyruvate‐kinase (PK) activity, phospho‐fructo‐kinase (PFK) activity, HbF level, red cell antigens production and bone marrow sideroblasts, has been studied in 31 patients with myelomatosis and in 33 patients with nonhaematological malignancies. We have demonstrated the appearance after chemotherapy or radiotherapy of some abnormalities usually associated with leukaemia or preleukaemic states. In patients treated for myelomatosis, a PK deficiency has been detected in 58 % of the cases, an increased HbF level in 47 %, a modification of blood groups antigens in 68 % and abnormal sideroblasts in 30 %. No PFK deficiency was found. In patients treated for solid tumors, a PK deficiency in 50 % of the cases, a PFK deficiency in 20 %, an increased HbF level in 10 %, a modification of blood group antigens in 40% has been detected. Chemotherapy administered over a period of 3 months has been shown to induce these abnormalities. Localized radiotherapy may have a similar effect. The combination of these two factors seems to cause an increase in the frequency and intensity of these abnormalities.