The hematotoxicity of
benzene exposure has been well known for a century.
Benzene causes
leukocytopenia,
thrombocytopenia,
pancytopenia, etc. The clinical and hematologic picture of
aplastic anemia resulting from
benzene exposure is not different from classical
aplastic anemia; in some cases, mild
bilirubinemia, changes in osmotic fragility, increase in lactic
dehydrogenase and fecal
urobilinogen, and occasionally some neurological abnormalities are found. Electromicroscopic findings in some cases of
aplastic anemia with
benzene exposure were similar to those observed by light microscopy.
Benzene hepatitis-
aplastic anemia syndrome was observed in a technician with
benzene exposure. Ten months after occurrence of
hepatitis B, a severe
aplastic anemia developed. The first epidemiologic study proving the leukemogenicity of
benzene was performed between 1967 and 1973 to 1974 among shoe workers in Istanbul. The incidence of
leukemia was 13.59 per 100,000, which is a significant increase over that of
leukemia in the general population. Following the prohibition and discontinuation of the use of
benzene in Istanbul, there was a striking decrease in the number of leukemic shoe workers in Istanbul. In 23.7% of our series, consisting of 59 leukemic patients with
benzene exposure, there was a preceding pancytopenic period. Furthermore, a familial connection was found in 10.2% of them. The 89.8% of our series showed the findings of acute
leukemia. The possible factors that may determine the types of
leukemia in
benzene toxicity are discussed. The possible role of
benzene exposure is presented in the development of
malignant lymphoma,
multiple myeloma, and
lung cancer.