Relation among occupational exposure to potential mutagenic/carcinogenic agents, clinical findings, and bone marrow chromosomes in acute nonlymphocytic leukemia.

The chromosome banding pattern of bone marrow cells and clinical findings, including cytologic diagnosis, response to therapy, and survival time, were compared in two groups of adult patients with acute nonlymphocytic leukemia (ANLL): 23 patients occupationally exposed to chemical solvents, insecticides, and petrol products and 33 patients with no history of occupational exposure to potential mutagenic/ carcinogenic agents. As regards clinical findings, cases classified as AML were more common in the exposed group, whereas the monocytic varieties of ANLL were more common in the nonexposed group; neither the complete remission rate nor the median survival differed significantly. In both groups patients with only abnormal metaphases had poorer prognoses than those with normal bone marrow metaphases only. The detailed karyotypic findings showed striking differences between the two groups: ( 1 ) in the nonexposed group only 24.2% had chromosome aberrations, whereas 82.6% of the cxposed patients had aberrations; (2) in the exposed group 84.2% of the patients with aberrations had at least one of four particular changes-monosomy 5 or 7 or trisomy 8 or 21, but in the nonexposed group none of the patients had monosomy 5 or trisomy 8, and only one patient had monosomy 7 and one had trisomy 2 1. None of the remaining aberrations seen in the nonexposed group were found in any of the exposed individuals.