Etude clinique et cytogénétique de 21 patients atteints de leucémie myéloïde chronique

Abstract

1. 1. Thirty-one cytogenic studies were performed on 18 patients with chronic myelogenous leukaemia (CML). The Ph 1 chromosome was found in each case (in 12–100% of the mitoses, mean 69%) in the chronic phase as well as during the acute transformation. The modal number of chromosomes was 46 for the 13 patients in chronic phase and for 6 patients during the myeloblastic crisis. Aneuploidy was present in 2 cases in the blastic phase. In another patient, the modal number was 49, a few weeks before death, without acute myeloblastic crisis. The patient had secondary haemolytic anaemia and severe thrombocytopenia. 2. 2. In a 12-year-old girl with CML, there were 2 Ph 1 chromosomes in 85% of the mitoses. 3. 3. In one case of chronic neutrophilic leukaemia, there was a karyotype with a modal number of 46 chromosomes and the Ph 1 chromosomes was present in 31% of the mitoses. 4. 4. In one case with the clinical and haematological characteristics of agnogenic myeloid metaplasia (anaemia, mild leukocytosis, thrombocythemia, survival of 8 years without treatment), the Ph 1 chromosome was found in 18% of the mitoses. 5. 5. The leukocyte alkaline phosphatase (LAP) activity was studied by the method of Kaplow in all cases. It was low in all the patients with typical CML in the chronic phase. It was slightly higher, but still below the median, in 2 patients in complete remission. It was normal or high in three cases during the acute blastic crisis. In one of these, 2 Ph 1 chromosomes were present in the majority of the mitoses. In addition the LAP was high in the case of CML in a girl who also showed 2 Ph 1 chromosomes. The LAP score was extremely high in the case of chronic neutrophilic leukaemia.