Abstract
A 71-year-old man was admitted to our hospital because of leukocytosis in September, 1984. At the time of diagnosis of CML, all of the metaphases of bone marrow cells analyzed were Ph1-positive without other chromosomal anomalies. He was given a new nitrosourea derivative, MCNU, in a total dose of 1050 mg, and became pancytopenic in November. Cytogenetic analysis of the bonem marrow in November showed no Ph1 chromosome in the 20 metaphase cells. LAP activity in the peripheral blood rose to the normal level. Following MCNU-induced bone marrow hypoplasia, he maintained complete remission both hematologically and cytogenetically without therapy until June, 1985. Subsequent gradual hematological recovery was associated with an increasing percentage of Ph1 positive cells but not with a reduction of LAP activity. Sixteen months after the karyotypic conversion all marrow cells acquired Ph1 chromosome again, and LAP score returned to the pretreatment level 23 months after.
The patient now remains well in chronic phase of CML 30 months after the diagnosis.
