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Proliferation and Differentiation of Murine Myeloid Precursor 32D/G-CSF-R Cells
Published on: February 21, 2018
[Extramedullary blastic transformation in chronic granulocytic leukemia]
A Vidović1, G Janković, N Suvajdzić
1Institut za hematologiju UKC, Beograd.
Srpski Arhiv Za Celokupno Lekarstvo
|January 1, 1993
Summary
Philadelphia chromosome-positive chronic granulocytic leukemia can develop extramedullary blast crisis, even after long-term busulfan treatment. This case highlights lymphoblastic infiltration in lymph nodes and poor prognosis despite COP protocol therapy.
Area of Science:
- Hematology
- Oncology
- Pathology
Background:
- Chronic granulocytic leukemia (CGL), characterized by the Philadelphia chromosome (Ph1), is a myeloproliferative neoplasm.
- Busulfan is a chemotherapy agent historically used for CGL treatment.
- Extramedullary blast transformation (crisis) represents disease progression with blast infiltration outside the bone marrow.
Observation:
- A patient with Ph1-positive CGL presented with extramedullary blast crisis in cervical and axillary lymph nodes.
- This complication occurred after a 4-year treatment course with busulfan.
- Histopathological examination of lymph node biopsies revealed lymphoblastic infiltration.
Findings:
- The patient received radiotherapy and chemotherapy using the COP (Cyclophosphamide, Oncovin, Prednisone) protocol.
- Survival following diagnosis of extramedullary blast crisis was limited to 7 months.
- The patient ultimately succumbed to renal insufficiency.
Implications:
- This case underscores the potential for CGL to transform into lymphoblastic leukemia with extramedullary involvement.
- It highlights the limitations of prolonged busulfan therapy in preventing advanced disease transformation.
- The poor prognosis emphasizes the need for alternative or combination therapies in managing advanced CGL and its complications.
