The coexistence of acute leukemia and Hodgkin's disease is rare.1 However, Crosby 2 in a recent survey estimated the incidence of acute granulocytic leukemia in Hodgkin's disease to be increased tenfold, and suggested that this may be a sequel to radiotherapy, not directly related to the disease. We present here two patients with Hodgkin's disease of long duration, in both of whom acute leukemia developed. A refractory sideroblastic anemia, which rapidly progressed to erythroleukemia (acute Di Guglielmo syndrome) developed in one; pancytopenia developed in the other, who died of acute granulocytic leukemia nine months later.
In 1954, a 36-year-old woman had Hodgkin's disease involving cervical, supraclavicular, and mediastinal nodes. She received radiotherapy (2,400 roentgens) to these areas. Laboratory values were as follows: hemoglobin, 12.4 gm/ 100 ml; leukocytes, 9,100/cu mm, with 58% neutrophils, 21% lymphocytes, 16% monocytes, and 5% eosinophils. In 1960, adenopathy recurred, with systemic symptoms.