Phenotypic changes in a case of blast crisis of CML

Characterization by TdT, cytochemistry, and cytogenetics

Elisabeth M. Paietta, J. D. Schwarzmeier

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Phenotypic changes in blast crisis of a case of Philadelphia chromosome (Ph1)-positive chronic myelogenous leukaemia were characterized by serial terminal transferase (TdT) determinations simultaneously related to cytochemical and cytogenetic data. At the onset of the blast crisis, 90% of the blast cells were acid phosphatase-positive (focal pattern), Ph1-positive, lymphoid cells. The TdT activity amounted to 29 units/108 mononuclear cells in the peripheral blood and to 57 units/108 mononuclear cells in the bone marrow. Therapy with vincristine and prednisone caused the elimination of the TdT-positive cell population. 4 months later, there was an increase in TdT-negative, myeloid blasts which was brought under control with busulfan. Cytogenetic analysis of the myeloid blasts still revealed Ph1 positivity in 100% of the metaphases examined and the lack of additional chromosomal abnormalities. A second relapse was again dominated by TdT-containing cells with the 46,XX,Ph1 karyotype. This time, the patient failed to achieve remission with vincristine and prednisone. Even though the TdT activity was markedly decreased, the lymphoid blast count remained elevated and the cells showed resistance to further therapy. This failure of morphology, cytochemistry as well as cytogenetics to distinguish between the individual phenotypes emerging during the course of blast crisis of CML characterized the TdT as a cell marker of important diagnostic and therapeutically prognostic value.

Original languageEnglish (US)
Pages (from-to)241-246
Number of pages6
JournalScandinavian Journal of Haematology
Volume27
Issue number4
StatePublished - 1981
Externally publishedYes

Fingerprint

Blast Crisis
Histocytochemistry
Cytogenetics
Vincristine
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Prednisone
Busulfan
Philadelphia Chromosome
Cytogenetic Analysis
Metaphase
Transferases
Acid Phosphatase
Karyotype
Chromosome Aberrations
Bone Marrow Cells
Lymphocytes
Phenotype
Recurrence
Therapeutics
Population

ASJC Scopus subject areas

  • Hematology

Cite this

Phenotypic changes in a case of blast crisis of CML : Characterization by TdT, cytochemistry, and cytogenetics. / Paietta, Elisabeth M.; Schwarzmeier, J. D.

In: Scandinavian Journal of Haematology, Vol. 27, No. 4, 1981, p. 241-246.

Research output: Contribution to journalArticle

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