The occurrence of acute leukemia in patients with chronic lymphocytic leukemia is being reported with increasing frequency.1-31 Although the majority of these cases have been described as "acute blastic terminal phase" or as straightforward lymphoblastic in nature, a substantial number of patients' terminal acute leukemia has been described as myeloblastic, monocytic, and myelomonocytic, which raises the question of a separate origin to this terminal acute leukemia. A review and analysis of the literature are the substance of this report.
In 1949, Lawrence et al1 described 100 patients with chronic lymphocytic leukemia treated with radioactive phosphorus (32P). Fifty-eight of the patients also received local radiation to spleen or lymph nodes either prior to or subsequent to the32P therapy. Two of the 100 patients developed "acute leukemia with increased numbers of blast cells in the blood smear" (type not stated). The following year, another report