[Philadelphia chromosome-positive chronic myeloid leukemia with washing out of Ph'-negative lymphoid blasts and with meningiosis: atypical blast crisis or a 2d leukemia?].
The case of a 53-year-old female with a Philadelphia-chromosome (Ph')-positive chronic myeloid leukemia (CML) is reported. In this patient, a first lymphoid blast crisis developed after a chronic period of 20 months. Treatment with vincristine and prednisone was successful. A few weeks later she presented with meningeal leukemia with lymphoid blastic cells in CSF and a facial nerve palsy, while the peripheral blood showed the typical picture of CML. Meningeal leukemia was successfully treated with cranial irradiation and intrathecal chemotherapy. Later on, a second lymphoid blast crisis (blasts of "common acute leukemia" type) was observed. Again, chemotherapy with vincristine and prednisone was successful. After 2 1/2 weeks, however, a third lymphoid blast crisis developed. At this moment, Ph'-chromosome was undetectable in unstimulated cells of the peripheral blood. The question of an additional leukemia is discussed.
D002874:Chromosome Mapping; D002904:Chromosomes, Human, 21-22 and Y / Q000648:ultrastructure*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007621:Karyotyping; D007951:Leukemia, Myeloid / Q000188:drug therapy / Q000235:genetics*; D008577:Meningeal Neoplasms / Q000188:drug therapy / Q000235:genetics*; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000188:drug therapy / Q000235:genetics*; D011241:Prednisone / Q000627:therapeutic use; D014750:Vincristine / Q000627:therapeutic use
D014750:Vincristine; D011241:Prednisone
Philadelphia-Chromosom-positive chronische myeloische Leukämie mit Ausschwemmung Ph'-negativer lymphoider Blasten und mit Meningosis: atypischer Blastenschub oder Zweitleukämie?