A case of chronic myeloid leukemia without Ph1 translocation

A case of chronic myeloid leukemia (CML) with a short survival (11 months) is described. Cytogenetic peculiarities of the bone marrow cells analyzed by G-banding consisted of a Ph1 chromosome with no translocation and a translocation t(5;13). Hematological characteristics were marked leukocytosis and massive splenomegaly. After treatment with busulfan complete hematological remission was achieved, followed by the appearance of a normal clone. However, 6 months later the patient entered the blastic crisis and a hyperdiploid clone appeared. The usual chemotherapy was given, but the patient responded only partially and died with a prevalence of pathologic myeloblasts in the bone marrow, corresponding to progression of the hyperdiploid clone.