Which client is at greatest risk for development of acute leukemia?
A. 50-year-old being treated with cyclophosphamide (Cytoxan) for a chronic au-toimmune disease
B. 55-year-old with diabetes mellitus type 1 who has received insulin injections for 43 years
C. 20-year-old with cystic fibrosis who has been on continuous enzyme replacement therapy since age 3 months
D. 38-year-old who has used combination oral contraceptives without a break for 15 years
A
Cyclophosphamide is a cytotoxic agent that damages bone marrow and has been known to in-duce leukemia.
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