A 51 year old health nurse had helped X ray photography for 22 years without any protector. Her routine medical check up in September, 1973, showed WBC 14400/cumm, appearance of immature granulocytes, basophilia in peripheral blood and predominant granulocytes series in bone marrow. But she did not have splenomegaly, low neutrophil alkaline phosphatase score, confirmed Ph
1 chromosome and marked neutrophilia.
We thought she was in early stage of CML and kept observing her clinical course, but she was admitted with chief complaints of general malaise, slight fever and pain of lower legs in April, 1974. Findings in physical and laboratory examinations on admission were as follows: slight splenomegaly, accelerated blood sedimentation rate, 12.5% myeloblasts in peripheral blood, 37.6% myeloblasts in bone marrow and positive Ph
1 chromosome.
At this stage, she was regarded to be in blast crisis of CML. The administration of 6MP and prednisolone brought the blast crisis back to chronic phase of CML, but two months later, blast crisis developed again.
She died of sepsis and pulmonary hemorrhage in December, 1974.
Some aspects of the atypical course were discussed.
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