抄録
A case of chronic myelogenous leukemia initiating as lymphoid crisis is reported. A 11-year-old girl was admitted because of fever, lenkocytosis and hepatosplenomegaly on November 10th, 1981. The patient was diagnosed into high risk acute lymphoblastic lenkemia because of her age (older than ten years), high leukocyte count (14,500/cmm with 98.8% blasts), hepatosplenomegaly, and leukemic cells being peroxidase negative and PAS positive. The surface marker studies and enzyme activities of the leukemic cells revealed the characteristics of non-T, non-B acute lymphoblastic leukemia. She was treated with vincristine, L-asparaginase, daunomycin, and prednisolone and complete remission was achieved five weeks after the initiation of therapy. It must be noted, however, that the karyotype of the bone marrow cells was 46, XX, t (9; 22; 12) at the time of hematological complete remission as well as at onset. Three months after the patient relapsed and died of septicemia on December 10th, 1982 in spite of vigorous chemotherapy.
She was classified into adult type chronic myelogenous leukemia because of the persistent predominance of Ph1 positive cells while in hematological complete remission. The authors concluded that cytogenetic findings have preference to morphological appearance of lymphoid cells. Besides, the patient had unusual chromosome pattern such as t (9; 22; 12), which has not seen in previous reports regarding to leukemia and chromosome.
