Immunophenotypic and genotypic characteristics of chronic myelogenous leukemia in blast crisis

C. C. Yen, J. H. Liu, W. S. Wang, F. S. Fan, T. J. Chiou, C. J. Tai, M. H. Yang, T. C. Chao, L. T. Hsiao, P. M. Chen

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5 引文 斯高帕斯(Scopus)

摘要

Background. Chronic myelogenous leukemia (CML) may transform into blast crisis (BC) if not properly treated. Among patients with transformation, 20% to 30% will develop BC with lymphoid-associated antigens (Ly-BC), and the remaining cases with myeloid-associated antigens (My-BC) or with both (Mix-BC). In this study, we investigated the lineage of blast cells in CML-BC using immunophenotypic and genetic analyses and analyzed the prognostic significance of genotypic change in CML-BC. Methods. Twenty-one patients with CML-BC diagnosed at the Taipei Veterans General Hospital from 1982 to 1992 were included. Immunophenotyping was done by using the avidin-biotin immunoperoxidase technique. Genetic analyses were carried out by using Southern Blot hybridization. The prognostic influence of genotypic change was analyzed. Results. Thirteen patients (61.9%) expressed myeloid-associated antigens, one patient (4.8%) expressed megakaryoblast-associated antigens, four patients (19%) expressed B lymphoid-associated antigens and three patients (14.3 %) expressed both myeloid and B lymphoid antigens. Clonal rearrangement of the immunoglobulin heavy chain (IgH) gene was found in six cases. Among them, four expressed B lymphoid markers only and two expressed both myeloid and B lymphoid markers. Patients with clonal IgH gene rearrangement tended to have a better response to chemotherapy (50% vs 8.3%, p = 0.08) and significantly longer survival (median survival, 5 months vs 3 months, p <0.05) than did those with a germline configuration. Conclusions. Clonal rearrangement of the IgH gene was found mostly in cases of Ly-BC and Mix-BC. We found that CML-BC with clonal rearrangement of the IgH gene had a more favorable prognosis than in cases with a germline configuration.

原文英語
頁(從 - 到)785-791
頁數7
期刊Chinese Medical Journal (Taipei)
63
發行號11
出版狀態已發佈 - 2000
對外發佈

ASJC Scopus subject areas

  • 醫藥 (全部)

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