1967 Volume 8 Issue 1 Pages 21-26
Incidence of the acute exacerbation has been markedly high when the cases died of such complication as infection were excluded, in the 32 cases of chronic myelogenous leukemia who have been observed until their death in our clinic since 1937.
Although the incidence was not higher among myleran treated cases as compared to the cases receiving other treatments, among 11 cases who had been treated with myleran and developed the acute exacerbation, 5 cases (45%) showed the signs of the acute exacerbation within 20 months after the establishment of the diagnosis of chronic myelogenous leukemia.
This percentage was apparently higher than that observed in cases treated with X-irradiation or another chemicals. Therefore, a possibility that the myleran therapy could accelerate the development of the acute exacerbation was speculated from our present study.
The acute exacerbation tended to occur more frequently in the period of myleran induced remission than in the relapsing phase of chronic myelogenous leukemia.
Hematological changes suggesting the acute exacerbation occurred first in bone marrows followed by similar changes in peripheral blood. In one case of acute exacerbation, however, an increase in the number of blasts in peripheral blood preceded, and the bone marrow examination did not reveal any signs of acute exacerbation at that time.
Prodromal signs of the acute exacerbation were arthralgia, bone pains, anemia, and thrombocytopenia. Increase in the serum CRP-titer was also noted in our cases suggesting its diagnostic significance.
