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[Characteristics of clonal evolution in patients with myelocytic leukemia].

The authors report the results of the clinical, cytochemical, cytogenetic and kinetic studies (3H-thymidine autoradiography and scanning integrating cytospectrophotometry of DNA) in a male patient with chronic myeloleukemia with blast infiltration of the lymph nodes. Analysis of the karyotype and kinetic aspects of leukemic cells obtained from the blood, bone marrow, spleen and hyperplastic lymph nodes was performed over time at different disease periods. Based on the data obtained the authors suggest that aneuploid blasts may maturate before segmented granulocytes. The probability of the medullary origin of aneuploid clones is discussed.

Bone Marrow

Clonal evolution of karyotype in blastic phase of CML.

A patient with chronic myelocytic leukemia (CML) had a Philadelphia chromosome--Ph1(t(9q +; 22q--)) in all evaluated bone marrow cells at the time of diagnosis. After 29 months of intermittent therapy (chemotherapy and immunotherapy) and 2 months before clinical signs of blastic phase developed, three additional cell lines in bone marrow and peripheral blood appeared: one line with extra chromosome Ph1, another one in which chromosome Y disappeared, and the third line with extra chromosome No. 13, evidently derived from the X-monosomie cell line. Five weeks before death a variable hypodiploidy was found in more than 50% mitoses. The patient died 47 months after the establishment of CML and seven months after the onset of the blastic phase.

Chromosome Aberrations