[Auer bodies and Ph1 chromosome: chronic myeloid pseudoleukemia?]

In 4 cases, the probable diagnosis was that of a chronic myeloid leukaemia (CML) in a blast crisis, because of the sudden acute onset and the presence of the Ph 1 chromosome. In each case, however, there were Auer bodies in the blasts, an unusual finding in CML. Cytological and cytochemical examination led respectively to the diagnosis of an M2 acute myeloblastic leukaemia (AML), according to the FAB classification, to that of a pre-leukaemia progressing to an M2 AML, to that of a M3 promyelocyte leukaemia, with numerous monocytes and finally, in one case, the diagnosis lay between a possible acute crisis of CML with Auer bodies or an acute myelo-monocyte leukaemia. These atypical findings did not conform to the classic picture of CML and cannot be classified as such in spite of the presence of the Ph 1 chromosome. To consider them as true CML would be to run a risk of distorting the haematological evolutive and therapeutic aspects of this disease.