Abstract
The authors report a rare case of chronic myelogenous leukemia (CML) in which the Ph1 clone disapeared after remission induction of lymphoid crisis. A 58-year-old man was admitted to our hospital because of fever in July 1988. The white cell count was elevated. Bone marrow aspirate showed hypercellularity with myeloid hyperplasia. In the chromosomal analysis, Ph1 chromosomes were detected in 100% of bone marrow cells analysed. Diagnosis of CML was made and treatment was initiated with recombinant interferon-α 2a. Hemotological remission without cytogenetic improvement was achieved. In March 1990 he developed lymphoid crisis with proliferation of CD10-positive cells. The chromosomal analysis revealed additional abnormalities including, 45, X, -Y, t(9;22)(q34;q11), +1, -8. With vincristine 0.6 mg×4, pirarubicin 15 mg×4, dexamethasone 40 mg×4 therapy complete remisson was obtained. In December 1990 the Ph1 positive clone completely disappeared judging from normal karyotypes in the chromosomal analysis and the disapearance of M-bcr gene rearrangement.
