To the editor: Although acute leukemia is a potential long-term complication of alkylating agent therapy (1), interactions between these drugs and radiation therapy or radiomimetic drugs are poorly understood. Doxorubicin (adriamycin) is a radiomimetic drug carcinogenic to laboratory animals (2). It is frequently used in conjunction with cyclophosphamide and radiation therapy for various solid tumors. We have recently evaluated a patient who developed acute leukemia after such combined modality therapy.
A 56-year-old white woman received preoperative pelvic radiation (5000 rad) in February 1976 for an adenosquamous carcinoma of the endometrium. At surgery, her uterus and both ovaries contained tumor, and