1973 Volume 14 Issue 12 Pages 1206-1211
A 46-year-old male, manager, was admitted to the hospital because of right hypochondrial pain. He had been well until 8 years previously, when this pain began and he was diagnosed as cholelithiasis. He had not received surgical operation.
The examination of blood revealed white blood cell count of 7200 (for 2 weeks before admission, he was treated with 6 MP and steroids on suspicion of AML) with 11% basophils, thrombocyte count of 150×104 and neutrophil alkaline phosphatase (NAP) activity was 85% positive and score 219. Repeated examination revealed remarkable basophilia, thrombocytosis and high NAP activity. In bone marrow, basophilia was observed, atypical megakaryocytes were not seen and also normal in number, cytogenetic study of bone marrow gave positive PhI chromosome.
We consider this basophilia as accompanied phenomenon or basophilic leukemoid reaction in the early stage of CML and thrombocytosis as the same phenomenon rather than thrombocythemia by the reason of no atypical megakaryocytes in bone marrow. Although low NAP activity is characteristic of CML, many cases with high NAP activity have been reported.
Ultimately presence of PhI chromosome was the key for diagnosis in this case.
