Heterogeneity of morphological, cytochemical, and cytogenetic features in the blastic phase of chronic granulocytic leukemia

• Published in: Cancer Vol. 35; no. 1; pp. 199 - 207
• Main Authors: Shaw, Michael T., Bottomley, Richard H., Grozea, Petre N., Nordquist, Robert E.
• Format: Journal Article
• Language: English
• Published: New York Wiley Subscription Services, Inc., A Wiley Company 01.01.1975
• Subjects: Acute Disease; Adult; Alkaline Phosphatase - metabolism; Aneuploidy; Biopsy; Bone Marrow - enzymology; Bone Marrow - ultrastructure; Bone Marrow Cells; Cell Nucleus - ultrastructure; Child; Chromosome Aberrations; Cytarabine - therapeutic use; Cytoplasm - ultrastructure; Female; Histocytochemistry; Humans; Leukemia, Myeloid - drug therapy; Leukemia, Myeloid - pathology; Male; Microscopy, Electron; Middle Aged; Mitochondria; Organoids - ultrastructure; Peroxidases - metabolism; Prednisone - therapeutic use; Remission, Spontaneous; Staining and Labeling; Thioguanine - therapeutic use; Vincristine - therapeutic use
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/1097-0142(197501)35:1<199::AID-CNCR2820350124>3.0.CO;2-9

Possible predicitive criteria of the refractorness to therapy of the blastic phase of PH1‐positive chronic granulocytic leukemia (CGL) have been sought. Eight cases in the blastic phase were studied. The blasts were noted to be of two types: some displayed a high nuclear: Cytoplasmic ratio with deep blue cytoplasm, while others had a comparatively low nuclear: cytoplasmic ratio and bluish gray cytoplasm containing a few small granules. Electron microscopic studies showed a variety of features, including defective organcelles and giant mitochondria. Cytochemical staining revealed the majority of blast cells to be peroxidase‐ and sudan black‐negative; granular PAS positivity oas the rule. Serial cytogenetic studies demonstrated increasing aneuploidy. Bone marrow biopsy showed myclofibrotic changes in two cases. Two patients entered complete remission with prednisone and vincreistine and with Ara‐C and thioguanine, respectively. It is concluded that the blastic phase of CGL may manifest heterogeneity.