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Chronic Myelogenous Leukemia With Myelofibrosis: Four Years After Auto-immune Hemolytic Anemia

Chronic Myelogenous Leukemia With Myelofibrosis: Four Years After Auto-immune Hemolytic Anemia Abstract ALTHOUGH in typical cases myelofibrosis with myeloid metaplasia is distinguishable from chronic myelogenous leukemia, there exist a number of cases in which the abnormalities are sufficiently similar to make differential diagnosis difficult. The extreme case of myelofibrosis shows complete replacement of hematopoietic elements by connective tissue, either fibrous or osseous or both, and the classical chronic myelogenous leukemic marrow is hypercellular with a striking granulocytic preponderance, increased megakaryocytes, and normal nucleated or occasionally "megaloid" erythrocytes. However, the marrow pictures in the two conditions may be almost identical since myelofibrosis may be preceded or accompanied by hyperplasia of the marrow,1 and the marrow of undoubted cases of chronic myelogenous leukemia may show fibrosis in the later stages of the disease.2 These cases have raised the question of whether myelofibrosis with myeloid metaplasia and chronic myelogenous leukemia are different manifestations of the same fundamental disturbance.3 Newer techniques such as chromosome analysis and References 1. Dameshek, W., and Gunz, F.: Leukemia , ed 2, New York: Grune & Stratton, Inc, 1964, p 365. 2. Hutt, M.S.R.; Pinniger, J.L.; and Wetherley-Mein, G.: The Myeloproliferative Disorders With Special Reference to Myelofibrosis , Blood 8:295, 1953. 3. Dameshek, W., and Gunz, F.: Leukemia , ed 2, New York: Grune & Stratton, Inc, 1964, p 366. 4. Tough, I.M., et al: Cytogenetic Studies on Bone Marrow in Chronic Myeloid Leukemia , Lancet 1:844, 1963.Crossref 5. Heath, C.W., and Moloney, W.C.: The Philadelphia Chromosome in an Unusual Case of Myeloproliferative Disease , Blood 26:471, 1965. 6. Krauss, S.: Chronic Myelocytic Leukemia With Features Simulating Myelofibrosis With Myeloid Metaplasia , Cancer 19:1321, 1966.Crossref 7. Forrester, R.H., and Louro, J.M.: Philadelphia Chromosome Abnormality in Agnogenic Myeloid Metaplasia , Ann Intern Med 64:622, 1966.Crossref 8. Tjio, J.H., and Whang, J.: Chromosome Preparations of Bone Marrow Cells Without Prior in vitro Culture or in vivo Colchicine Administration , Stain Tech 37:17, 1962. 9. Lau, K., et al: Measurement of Vitamin B12 Level Using Radioisotope Dilution and Coated Charcoal , Blood 26:202, 1965. 10. Gottlieb, C., et al: Rapid Charcoal Assay for Intrinsic Factor, Gastric Juice, Unsaturated B12 Binding Capacity, Antibody to IF., and Serum Unsaturated B12 Binding Capacity , Blood 26:875, 1965. 11. Retief, F., et al: Unsaturated B12 Binding Capacity of Serum in Diagnosis of Chronic Myelogenous Leukemia , Clin Res 13:542, 1965. 12. Beard, M.F., et al: Serum Concentrations of Vitamin B12 in Patients Suffering From Leukemia , Blood 9:789, 1954. 13. Mollin, D.L., and Ross, G.I.: Serum Vitamin B12 Concentration in Leukemia and in Some Other Hematological Conditions , Brit J Haemat 1:155, 1955.Crossref 14. Racuglia, G., and Sacks, M.S.: Vitamin B12 Binding Capacity of Normal and Leukemic Sera , J Lab Clin Med 50:69, 1957. 15. Miller, A.: The in vitro Binding of Cobalt60 Labeled Vitamin B12 by Normal and Leukemic Sera , J Clin Invest 37:556, 1958.Crossref 16. Meyer, L.M.: Studies on Serum Binding of Vitamin B12 Mechanisms and Clinical Implications , Series Haemat 3:91, 1965. 17. Britt, R.P., and Rose, D.P.: Pernicious Anemia With a Normal Serum B12 Level in a Case of Chronic Granulocytic Leukemia , Arch Intern Med 117:32, 1966.Crossref 18. Gottlieb, C., et al: Correlation of B12 Binding Proteins With Disorders of B12 Metabolism: Relation to Hypo and Hyperleucocytic States and Leucocyte Turnover , J Clin Invest 45:1016, 1966. 19. Mendelsohn, R.S., et al: Identification of Vitamin B12 Binding Proteins in Serum of Normal and of Patients With Chronic Myelocytic Leukemia , Blood 23:36, 1964. 20. Retief, F.; Gottlieb, C.; and Herbert, V.: Studies of Transfer of Protein Bound Co57B12 From Human Serum to Reticulocytes: Calcium Dependence, Decreased Transfer From Chronic Myelogenous Leukemia Serum , Blood 26:869, 1965. 21. Mitus, W.J.; Bergna, L.J.; and Mednicoff, I.B.: Alkaline Phosphatase of Mature Neutrophils in Chronic Forms of the Myeloproliferative Syndrome , Amer J Clin Path 30:285, 1958. 22. Nowell, P.C., and Hungerford, D.A.: Chromosome Studies in Human Leukemia: II. Chronic Granulocytic Leukemia . J Nat Cancer Inst 27:1013, 1961. 23. Sandberg, A.A., et al: Comparison of Chromosome Constitution in Chronic Myelocytic Leukemia and Other Myeloproliferative Disorders , Blood 20:393, 1962. 24. Krauss, S.; Sokal, J.E.; and Sandberg, A.A.: Comparison of Philadelphia Chromosome: Positive and Negative Patients With Chronic Myelocytic Leukemia , Ann Intern Med 61:625, 1964.Crossref 25. Dameshek, W.: Some Speculations on the Myeloproliferative Syndromes , Blood 6:372, 1951. 26. Wintrobe, M.: Clinical Hematology , ed 5, Philadelphia: Lea & Febiger. Publishers, 1961, p 925. 27. Moloney, W.C., and Lange, R.D.: Cytological and Biochemical Studies on Granulocytes in Early Leukemia Among Atomic Bomb Survivors , Texas Rep Biol Med 12:887, 1954. 28. Hayhoe, F.G.: Leukemia: Research and Clinical Practice , Boston: Little, Brown & Company, 1960, p 309. 29. Wasserman, L.R.: Polycythemia Vera—Its Course and Treatment: Relation to Myeloid Metaplasia and Leukemia , Bull NY Acad Med 30:343, 1954. 30. Osgood, E., and Seaman, A.: Treatment of Chronic Leukemias , JAMA 150:1372, 1952.Crossref 31. Videbaek, A.: Autoimmune Hemolytic Anemia in Some Malignant Systemic Diseases , Acta Med Scand 171:463, 1962.Crossref 32. Finkel, H., et al: Immunologic Aberrations, the DeGugliemo Syndrome , Blood 28:641, 1966. 33. Silverstein, M.N., and Heck, F.J.: Acquired Hemolytic Anemia and Associated Thrombocytopenia Purpura With Special Reference to Evans Syndrome , Mayo Clin Proc 37:122, 1962. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Chronic Myelogenous Leukemia With Myelofibrosis: Four Years After Auto-immune Hemolytic Anemia

Archives of Internal Medicine , Volume 119 (6) – Jun 1, 1967

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Publisher
American Medical Association
Copyright
Copyright © 1967 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1967.00290240142014
Publisher site
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Abstract

Abstract ALTHOUGH in typical cases myelofibrosis with myeloid metaplasia is distinguishable from chronic myelogenous leukemia, there exist a number of cases in which the abnormalities are sufficiently similar to make differential diagnosis difficult. The extreme case of myelofibrosis shows complete replacement of hematopoietic elements by connective tissue, either fibrous or osseous or both, and the classical chronic myelogenous leukemic marrow is hypercellular with a striking granulocytic preponderance, increased megakaryocytes, and normal nucleated or occasionally "megaloid" erythrocytes. However, the marrow pictures in the two conditions may be almost identical since myelofibrosis may be preceded or accompanied by hyperplasia of the marrow,1 and the marrow of undoubted cases of chronic myelogenous leukemia may show fibrosis in the later stages of the disease.2 These cases have raised the question of whether myelofibrosis with myeloid metaplasia and chronic myelogenous leukemia are different manifestations of the same fundamental disturbance.3 Newer techniques such as chromosome analysis and References 1. Dameshek, W., and Gunz, F.: Leukemia , ed 2, New York: Grune & Stratton, Inc, 1964, p 365. 2. Hutt, M.S.R.; Pinniger, J.L.; and Wetherley-Mein, G.: The Myeloproliferative Disorders With Special Reference to Myelofibrosis , Blood 8:295, 1953. 3. Dameshek, W., and Gunz, F.: Leukemia , ed 2, New York: Grune & Stratton, Inc, 1964, p 366. 4. Tough, I.M., et al: Cytogenetic Studies on Bone Marrow in Chronic Myeloid Leukemia , Lancet 1:844, 1963.Crossref 5. Heath, C.W., and Moloney, W.C.: The Philadelphia Chromosome in an Unusual Case of Myeloproliferative Disease , Blood 26:471, 1965. 6. Krauss, S.: Chronic Myelocytic Leukemia With Features Simulating Myelofibrosis With Myeloid Metaplasia , Cancer 19:1321, 1966.Crossref 7. Forrester, R.H., and Louro, J.M.: Philadelphia Chromosome Abnormality in Agnogenic Myeloid Metaplasia , Ann Intern Med 64:622, 1966.Crossref 8. Tjio, J.H., and Whang, J.: Chromosome Preparations of Bone Marrow Cells Without Prior in vitro Culture or in vivo Colchicine Administration , Stain Tech 37:17, 1962. 9. Lau, K., et al: Measurement of Vitamin B12 Level Using Radioisotope Dilution and Coated Charcoal , Blood 26:202, 1965. 10. Gottlieb, C., et al: Rapid Charcoal Assay for Intrinsic Factor, Gastric Juice, Unsaturated B12 Binding Capacity, Antibody to IF., and Serum Unsaturated B12 Binding Capacity , Blood 26:875, 1965. 11. Retief, F., et al: Unsaturated B12 Binding Capacity of Serum in Diagnosis of Chronic Myelogenous Leukemia , Clin Res 13:542, 1965. 12. Beard, M.F., et al: Serum Concentrations of Vitamin B12 in Patients Suffering From Leukemia , Blood 9:789, 1954. 13. Mollin, D.L., and Ross, G.I.: Serum Vitamin B12 Concentration in Leukemia and in Some Other Hematological Conditions , Brit J Haemat 1:155, 1955.Crossref 14. Racuglia, G., and Sacks, M.S.: Vitamin B12 Binding Capacity of Normal and Leukemic Sera , J Lab Clin Med 50:69, 1957. 15. Miller, A.: The in vitro Binding of Cobalt60 Labeled Vitamin B12 by Normal and Leukemic Sera , J Clin Invest 37:556, 1958.Crossref 16. Meyer, L.M.: Studies on Serum Binding of Vitamin B12 Mechanisms and Clinical Implications , Series Haemat 3:91, 1965. 17. Britt, R.P., and Rose, D.P.: Pernicious Anemia With a Normal Serum B12 Level in a Case of Chronic Granulocytic Leukemia , Arch Intern Med 117:32, 1966.Crossref 18. Gottlieb, C., et al: Correlation of B12 Binding Proteins With Disorders of B12 Metabolism: Relation to Hypo and Hyperleucocytic States and Leucocyte Turnover , J Clin Invest 45:1016, 1966. 19. Mendelsohn, R.S., et al: Identification of Vitamin B12 Binding Proteins in Serum of Normal and of Patients With Chronic Myelocytic Leukemia , Blood 23:36, 1964. 20. Retief, F.; Gottlieb, C.; and Herbert, V.: Studies of Transfer of Protein Bound Co57B12 From Human Serum to Reticulocytes: Calcium Dependence, Decreased Transfer From Chronic Myelogenous Leukemia Serum , Blood 26:869, 1965. 21. Mitus, W.J.; Bergna, L.J.; and Mednicoff, I.B.: Alkaline Phosphatase of Mature Neutrophils in Chronic Forms of the Myeloproliferative Syndrome , Amer J Clin Path 30:285, 1958. 22. Nowell, P.C., and Hungerford, D.A.: Chromosome Studies in Human Leukemia: II. Chronic Granulocytic Leukemia . J Nat Cancer Inst 27:1013, 1961. 23. Sandberg, A.A., et al: Comparison of Chromosome Constitution in Chronic Myelocytic Leukemia and Other Myeloproliferative Disorders , Blood 20:393, 1962. 24. Krauss, S.; Sokal, J.E.; and Sandberg, A.A.: Comparison of Philadelphia Chromosome: Positive and Negative Patients With Chronic Myelocytic Leukemia , Ann Intern Med 61:625, 1964.Crossref 25. Dameshek, W.: Some Speculations on the Myeloproliferative Syndromes , Blood 6:372, 1951. 26. Wintrobe, M.: Clinical Hematology , ed 5, Philadelphia: Lea & Febiger. Publishers, 1961, p 925. 27. Moloney, W.C., and Lange, R.D.: Cytological and Biochemical Studies on Granulocytes in Early Leukemia Among Atomic Bomb Survivors , Texas Rep Biol Med 12:887, 1954. 28. Hayhoe, F.G.: Leukemia: Research and Clinical Practice , Boston: Little, Brown & Company, 1960, p 309. 29. Wasserman, L.R.: Polycythemia Vera—Its Course and Treatment: Relation to Myeloid Metaplasia and Leukemia , Bull NY Acad Med 30:343, 1954. 30. Osgood, E., and Seaman, A.: Treatment of Chronic Leukemias , JAMA 150:1372, 1952.Crossref 31. Videbaek, A.: Autoimmune Hemolytic Anemia in Some Malignant Systemic Diseases , Acta Med Scand 171:463, 1962.Crossref 32. Finkel, H., et al: Immunologic Aberrations, the DeGugliemo Syndrome , Blood 28:641, 1966. 33. Silverstein, M.N., and Heck, F.J.: Acquired Hemolytic Anemia and Associated Thrombocytopenia Purpura With Special Reference to Evans Syndrome , Mayo Clin Proc 37:122, 1962.

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Jun 1, 1967

References