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Total body irradiation and human chromosomes III. Cytogenetic studies in patients with malignant hematologic diseases treated with total-body irradiation

The results of chromosomal analyses of 73 cultures obtained from 14 patients with various malignant hematologic diseases treated with total-body irradiation (TBI) are reported. The peripheral blood leukocytes were cultured before and at different intervals after TBI. In all eight previously untreated patients, increased chromosomal breakages were found after TBI. Of six previously treated patients, three (chronic myeloproliferative disorders) did not have increased breakages after TBI. These patients had been treated with 32P, TBI, busulfan, or combinations of these. An increase in breakages was found after TBI in the other three patients. These patients had been treated with local irradiation, prednisone, methotrexate, vincristine, and phenylalanine-mustard. Stable abnormal chromosomes such as a large acrocentric chromosome or a small G were seen in several metaphases. Some of these abnormal metaphases may continue to proliferate and become a clone of cells that result in another malignancy. Thus it is possible that there will be more patients developing a second cancer as we prolong the patients' lives with our currently available methods of treatment.