Heterogeneous blast cell crises in Philadelphia negative chronic granulocytic leukaemia

Br J Haematol. 1981 Apr;47(4):563-9. doi: 10.1111/j.1365-2141.1981.tb02685.x.

Abstract

A case of Philadelphia negative chronic granulocytic leukaemia (Ph1-CGL) is described showing features only previously demonstrated in Ph1+ disease. These features include: (1) lymphoid blast crisis, determined by morphology and immunological marker analysis; (2) dual blast cell populations that can be distinguished both morphologically and by immunological markers; (3) clonal evolution, as shown by the emergence of chromosome markers and in one of the cell lines a change in membrane phenotype. These changes were apparently associated with the emergence of a relatively drug resistant subclone of leukaemic cells. This study demonstrates that the lymphoid blast crisis of CGL, and its sequelae, can occur in Ph1- cases. It is similar in respect to morphology, enzyme, and membrane markers and responsiveness to vincristine and prednisolone therapy to the lymphoid blast crisis seen in Ph1+ CGL. This suggests that the Philadelphia chromosome is a clonal marker only, and its presence is not directly related to the subsequent clinical course of the disease.

Publication types

  • Case Reports

MeSH terms

  • Bone Marrow / ultrastructure
  • Chromosome Aberrations
  • Chromosomes, Human, 21-22 and Y*
  • Humans
  • Karyotyping
  • Leukemia, Myeloid / genetics
  • Leukemia, Myeloid / immunology
  • Leukemia, Myeloid / pathology*
  • Male
  • Middle Aged
  • Phenotype