抄録
We report a case of chronic myelomonocytic leukemia (COMMoL) which has been followed for 7 years and 4 months after onset. This case was considered to have the longest survival among the cases of CMMoL reported in Japan.
A 54-year-old male first noted bleeding tendency in January, 1975. At that time peripheral blood examination showed platelets 49×103/cmm and WBC 6,250/cmm with 16% monocytes. Accordingly, the absolute monocyte number was 1,000/cmm. Monocytosis persisted, and the absolutel monocyte number increased to 5,000/cmm in Apri, 1980.
In March, 1981, he was admitted to our hospital because of high fever and left hypochondralgia. On admission the spleen and liver were palpable 3 cm and 4.5 cm below the costal margins, respectively. The bone marrow showed slight hypercellularity with and an increase of granulocytes and monocytoid cells. The monocytoid cells showed moderately positive peroxidase reaction and positive non-specific esterase activity. Regarding phagocytosis, surface markers (Fcγ and C 3 receptors) and chemotaxis, they did not differ appreciably from the normal monocytes.
He died of an unexpected accident in April, 1981 and autopsy was performed. The spleen and liver were enlarged, weighing 445 and 1,750 g, respectively. The infiltration of mononuclear cells was seen moderately in the liver and slightly in the spleen. In the bone marrow, immature granulocytes and monocytoid cells proliferated but were not monotonus.
