Blastic transformation in chronic myelogenous leukemia: experience with 50 patients.
Fifty consecutive patients with blastic chronic myelogenous leukemia were evaluated clinically, morphologically, biochemically, and therapeutically. Forty-five patients had a preceding stable phase (38 Ph'+, 7 Ph'-); five patients presented with de novo Ph+ blast crisis. The most frequent clinical signs of impending blast crisis were weakness, fatigue, increasing splenomegaly, anemia, thrombocytopenia, marrow fibrosis, and a rising neutrophil alkaline phosphatase. Fever (unrelated to infection), skin infiltration, lymphadenopathy, hepatomegaly, thrombocytosis, and basophilia were much less common. The development of aneuploidy occurred in less than one-half of the total group. Myeloblastic morphology at blastic transformation was most frequent with occasional lymphoblastic, promyelocytic, and undifferentiated cases seen. Terminal deoxynucleotidyl transferase was present in one-third of the patients, but had no clear-cut relationship to the morphology. Response to treatment was generally disappointing (two complete and 15 partial remissions in 45 treated patients).
D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002874:Chromosome Mapping; D004254:DNA Nucleotidyltransferases / Q000097:blood; D005260:Female; D006801:Humans; D007945:Leukemia, Lymphoid / Q000175:diagnosis / Q000201:enzymology; D007951:Leukemia, Myeloid / Q000175:diagnosis* / Q000201:enzymology / Q000235:genetics; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis* / Q000201:enzymology / Q000235:genetics; D008297:Male; D008875:Middle Aged; D011379:Prognosis
D000970:Antineoplastic Agents; D004254:DNA Nucleotidyltransferases