RAEB in transformation induced by thorotrast

A 74-year-old male who received thorotrast for angiography in August, 1939, developed RAEB in transformation in 1982. Chromosome analysis of the marrow cells by short-term culture technique indicated complex abnormalities such as 5q-, t (7 ; 22) (q36 ; q11) and others. His illness was transformed into AML (M2) two months later, and he died of bronchopeumonia four months after the diagnosis inspite of the treatment with prednisolone, ACR and ACNU. It is suggested that Thorotrast may be related to leukemogenesis in this case because of the chromosome abnormalities and autopsy findings. In Japan 18 patients who had received Thorotrast developed erythroleukemia or RAEB, while thorotorast-induced leukemias were mainly AML, ALL and CML in England and Germany. The difference between Japan and Europe may be due to difference in the dosage of thorotrast. (author)