Acute leukemia occurred in two of 340 persons with chronic lymphocytic leukemia listed in a registry of leukemia cases among residents of Georgia. One case was acute myeloblastic leukemia; the cell type of the other was disputed. Before onset of acute leukemia, one patient had had numerous diagnostic x-rays, while the other had received therapeutic radiation. These data and previous case series indicate that acute leukemia in patients with chronic lymphocytic leukemia is rare, has no consistent cell type, and often follows exposure to therapeutic radiation. It seems possible that such cases of acute leukemia often represents a second malignancy than a true blast phase of chronic lymphocytic leukemia.

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