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Megakaryoblastic micromegakaryocytic crisis in chronic myeloid leukemia



277 51 51 4 4 G. Lingg F. Schmalzl J. Breton-Gorius A. Tabilio H. E. Schaefer D. Geissler M. Schweiger W. Kirchmair Department of Internal Medicine University of Innsbruck Austria Unité de Recherche sur les Anémies de l'Inserm Créteil France Department of Pathology University of Freiburg i Br FRG Institute of Medical Biology and Genetics University of Innsbruck Austria Summary Atypical megakaryoblasts (MKB) or megakaryocytes (MK) are occasionally present in the peripheral blood during the terminal development of chronic myeloid leukemia (CML). We report on a 49-year-old female suffering from Ph 1 chromosome-positive CML with typical megakaryoblastic transformation in the peripheral blood and in the bone marrow. The small “blasts” were at the most only slightly larger and were occasionally even smaller than lymphocytes but showed megakaryoblastic or atypical megakaryocytic differentiation. The cytoplasmic cytochemical pattern of the atypical megakaryocytic cells was identical to that of large atypical thrombocytes. Platelet peroxidase was detected upon electron-microscopic (EM) examination. Immunologic characterization disclosed the presence of MK-specific antigens. When cultured in vitro on agar, the blasts transformed spontaneously into large mature MK, exhibiting characteristic cytochemical and immunological patterns. Cytogenetic examination of peripheral blood showed severe abnormalities. The patient did not respond to therapy and died 3 months after manifestation of the blast crisis.



Annals of HematologySpringer Journals

Published: Oct 1, 1985

DOI: 10.1007/BF00320522

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