Five of 40 patients with chronic myeloid leukemia (CML) had lymphoid blast crisis and 4 of them achieved complete remission of metamorphosis with vincristine and prednisone. While in hematologic remission, two of these subjects developed meningeal leukemia. Clinical and biologic data indicated that the course of the disease after lymphoid blast crisis was very similar to that of acute lymphoblastic leukemia (ALL). It is suggested that patients with CML who develop lymphoid blast crisis should be treated with an intensive therapeutic protocol including early prevention of meningeal leukemia.
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References
1.
AtkinsonK.KayH.E.M.LawlerS.WellsD.G.McElwainT.J.: Meningeal leukemia after blastic transformation of chronic myeloid leukemia.Cancer, 35: 529–533, 1975.
2.
BaccaraniM.RuggeroD.TomasiniI.GuoloL.: Meningeal leukemia during blastic crisis.In: Second International Symposium on Therapy of Acute Leukemias, Abstracts, p. 185. Rome, 1977.
3.
BeardM.E.J.DurrantJ.CatovskyD.WiltshawE.AmessJ.L.BrearleyR.L.KirkB.WrigleyP.F.M.JanossyG.GreavesM.F.GaltonD.A.G.: Blast crisis of chronic myeloid leukaemia (CML). I. Presentation simulating acute lymphoid leukaemia (ALL).Br. J. Haematol., 34: 167–178, 1976.
4.
BrusamolinoE.BertazzoniU.IserniaP.GinelliE.ScovassiA.I.ZurloM.G.PlevaniP.SacchiN.BernasconiC.: Clinical relevance of terminal transferase and adenosine deaminase in leukemia.In: Terminal Transferase in Immunobiology and Leukemia, BertazzoniU. and BollumF.J. (Eds.), Plenum, New York, 1982 (in press).
5.
CanellosG.P.De VitaV.T.Whang-PengJ.CarboneP.P.: Hematologic and cytogenetic remission of blastic transformation in chronic granulocytic leukemia.Blood, 38: 671–679, 1971.
6.
CatovskyD.: Ph1-positive acute leukaemia and chronic granulocytic leukaemia: one or two diseases?Br. J. Haematol., 42: 493–498, 1979.
JanossyG.WoodruffR.K.PippardM.J.PrenticeG.HoffbrandA.V.PaxtonA.ListerT.A.BunchC.GreavesM.F.: Relation of « lymphoid » phenotype and response to chemotherapy incorporating vincristine-prednisolone in the acute phase of Ph1 positive leukemia.Cancer, 43: 426–434, 1979.
9.
MandelliF.AmadoriS.AlimenaG.AnninoL.NardelliS.PapaG.: Experience on the treatment of chronic myelocytic leukaemia (CML) in blastic crisis.Scand. J. Haematol., 19: 496–502, 1977.
10.
MarmontA.DamasioE.: The treatment of terminal metamorphosis of chronic granulocytic leukaemia with corticosteroids and vincristine.Acta Haematol., 50: 1–8, 1973.
11.
MooreM.A.S.: Marrow culture - a new approach to classification of leukemias.Blood Cells, 1: 149–158, 1975.
12.
MozzanaR.Della VolpeA.ChiorboliO.ColombiM.PolliE.E.: Meningosi leucemica nella crisi blastica della leucemia mieloide cronica. XVIII Congresso Nazionale della Società Italiana di Ematologia, Bari, 28–31 ottobre 1981, Volume delle Comunicazioni, p. 140.
13.
PetersonL.C.BloomfieldC.BrunningR.: Blast crisis as an initial or terminal manifestation of chronic myeloid leukemia. A study of 28 patients.Am. J. Med., 60: 209–220, 1976.
14.
PikeB.L.RobinsonW.A.: Human bone marrow colony growth in agar-gel.J. Cell Physiol., 76: 77–84, 1970.
RosenthalS.CanellosG.P.De VitaV.T.Jr., GralnickH.R.: Characteristics of blast crisis in chronic granulocytic leukemia.Blood, 49: 705–714, 1977.
17.
SchwartzJ.H.CanellosG.P.YoungR.C.De VitaV.T.Jr..: Meningeal leukemia in the blastic phase of chronic granulocytic leukemia.Am. J. Med., 59: 819–828, 1975.
TanakaM.KanedaT.HirotaY.YoshidaS.KitajimaK.: Terminal deoxynucleotidyl transferase in the blastic phase of chronic myelogenous leukemia: An indicator of response to vincristine and prednisone therapy.Am. J. Hematol., 9: 287–293, 1980.
20.
WoodruffR.K.MalpasJ.S.WrigleyP.F.M.ListerT.A.PaxtonA.M.JanossyG.: Meningeal leukaemia in lymphoid blast crisis of chronic myeloid leukaemia.Br. Med. J., 2: 1325–1326, 1977.
