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Rapidly fatal acute monocytic leukemia occurred in an 11-year-old by 33 months after the beginning of irradiation and chemotherapy for non-metastatic pelvic Ewing's sarcoma. At autopsy, no recurrent primary disease was seen. An analysis of this case together with a review of the literature suggests therapy-related leukemogenesis. Thus, the decline in mortality rate for childhood cancer may be accompanied by an increased incidence of second neoplasms in cured children having the potential of a normal life span.
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