Karyotype evolution and multilineage involvement of Philadelphia
chromosome-positive clones in blastic transformation of two patients with
chronic myelocytic leukemia
Y Sato, K Kitano, S Tsunoda, M Yoshida, E Kajii, T Suda, S Sakamoto, K Motoyoshi, M Saito and Y Miura
Department of Medicine, Jichi Medical School, Japan.
Simultaneous analysis of the cell morphology and karyotypes on single
colonies was carried out in two patients with Philadelphia chromosome
(Ph1)-positive chronic myelocytic leukemia in blastic transformation in
order to clarify the origin of leukemic cells involved. Patient no. 1 was
in a typical myeloblastic transformation and patient no. 2 in "basophilic
transformation." Both patients exhibited karyotype evolution in blastic
phase (BP), so that we could differentiate BP clones with additional
chromosomal abnormalities from chronic phase (CP) clones with only Ph1
among single colonies. The number of single colonies yielding two or more
analyzable metaphases was 18 in patient no. 1, and 19 in patient no. 2.
Among these colonies, only three in patient no. 1 and none in patient no. 2
were from CP clones and 15 in patient no. 1 and 19 in patient no. 2 were
from BP clones. Morphological examination revealed that not only blasts but
also mature neutrophils, eosinophils, basophils, macrophages, and
erythroblasts were derived from BP clones. These results suggested that (1)
BP clones developed at the pluripotent stem cell level, (2) additional
chromosomal abnormalities were not restricted to occur in a specific cell
line representative in BP; and (3) BP clones, if not all, may retain
capacity for maturation and differentiation.
Volume 71,
Issue 6,
pp. 1561-1567,
06/01/1988
Copyright © 1988 by The American Society of Hematology
