A 48-year-old woman, who had survived for 3 years after myeloid blastic crisis in Ph1-positive CML, was reported.
On admission, she had fever and marked splenomegaly. White blood cell counts were 89,800/mm3 including 31% myeloblasts and 13% promyelocytes. Seventy-three per cent of the blasts showed TdT activity, although positive for peroxydase reaction. She responded well to vincrisine (V) and prednisolone (P) (VP therapy) and steroid pulse therapy, and attained to the chronic phase of CML. Remission had been maintained with busulfan and VP therapy. However, she died of hepatic coma probably due to hepatitis B virus-induced liver cirrhosis 3 years after the onset of blastic crisis.
