Hepatitis and Leukemia

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To the editor: Barton and Conrad suggest in the February issue (1) that hepatitis may have a beneficial effect in acute myelocytic leukemia. They postulate that hepatitis may directly suppress the leukemia or that leukemic patients with hepatitis may be those with “greater immunocompetence and thus a better prognosis.” Several additional hypotheses should be considered. Patients with increased SGOT levels may not have hepatitis at all; rather their hepatocytes (and their leukemic cells) may be more sensitive to the antileukemic chemotherapy. For example, these patients may be lacking in cytarabine deaminase, thus accounting for higher and more prolonged cytarabine levels.

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