Abstract
In October 1978, a 64-year-old female was diagnosed as CMMoL because of monocytosis (8,500/mm3), myeloid hyperplasia in the bone marrow, positive non-specific esterase stain of leukocytes, and increased titer of the serum and urinary lysozyme. Her blood type was A type. Since her symptoms were subsided, she had been discharged and followed in the outpatient clinic. She, however, was re-admitted to our hospital because of fever, hepatosplenomegaly, and the increase of blastic cells. On the second admission, her blood type changed to Am type from A type. She was diagnosed as blastic crisis of CMMoL due to the increase of immatured monocytoid cells, increased monoblasts in the bone marrow, and thrombocytopenia. At that time, cytogenetic analysis of the peripheral blood cells revealed a karyotype of 46, XX, t (3 q-; 21 q+). After DCVP therapy, her blood type changed back from Am type to A type with a partial remission.
On blastic crisis, abnormalities of erythroid series—the alteration of the blood type—as well as myeloid series were found, therefore it was suggested that CMMoL blastic crisis results from the leukemic change of hemopoietic stem cells.
