Osteolytic lesion in chronic myelogenous leukaemia

Destructive bone lesion of the femur was observed in one patient from a series of 103 patients with CML. Numerous myeloblasts were seen on touch preparations of the fresh surgical specimen obtained by open biopsy of the affected area. Bone marrow and peripheral blood differential count were compatible with chronic phase of CML at this time. 5 months later blastic crisis developed. Local radiotherapy produced effective palliation of pain but did not prevent blastic transformation of CML. The treatment of blastic crisis was unsuccessful and patient died 3 years after diagnosis of CML, 6 months after the first clinical evidence of bone infiltration.     

Cytogenetic findings in chronic myelogenous leukemia

Cytogenetic findings in chronic myeloic leukemia are represented in a survey. More than 90 per cent of CML are characterized by Ph1 chromosomes, with more than 90 per cent of the cases being involved in a translocation (9; 22). Further, non-incidental aberrations are +Ph1, isochromosome (17q) and +8 which particularly develop at the acute stage. Isochromosome 17q is assumed to be a marker for a straightly impending development of a blast crisis. Ph1-negative CML is connected with a comparatively bad prognosis for the patient. Partial trisomy 9q+ is indicated here as a marker chromosome. For the patient concerned congenital chromosome defects, such as the Down-syndrome, represent a higher risk of being affected with leukemia.     

Aberrant breakpoints in chronic myelogenous leukaemia; oncogenes and fragile sites

Summary Three hundred and twenty-five aberrant breakpoints in chronic myelogenous leukaemia (CML) with Philadelphia chromosome variant were reviewed. Eight chromosomal bands (3p21, 6p21, 7p22, 11q13, 12p13, 17p13, 17q21, and 17q25) were found to be highly involved. Apart from 17q25, all these bands correspond to oncogenes sites and/or sites involved as primary breakpoints in cancer.This work was presented in part at the Congrès National d'Hématologie et de Transfusion Sanguine, March 1985 (Nouv Rev Fr Hématol, 1985, 27:72) and at the American Association for Cancer Research Meeting (Proceeding of the AACR 1986, 27:148)     

Masked Ph1-chromosome in chronic myelogenous leukaemia (CML)

The CML patients with so called masked Ph1-chromosome have been reviewed. Although the importance of c-sis and c-abl oncogenes is gaining popularity yet their role in the genesis of CML remain obscure. Patients with masked Ph1-chromosomes where chromosome 9 is not involved in the translocation(s) will provide a clue to the role of c-abl and/or c-sis in oncogenesis.     

Complex translocations,simple variant translocations and Ph-negative cases in chronic myelogenous leukaemia

Summary A proportion of cases of chronic myelogenous leukaemia (CML) has been described either (1) with a variant translocation, or (2) without the apparent involvement of both 9q34 and 22q11 (Ph-negative CML). All variant translocations have been further demonstrated to be complex implicating 9q34,22q11, plus another breakpoint on a variable chromosome. Complex translocations may be due to two successive events. Some of the breakpoints on the variable chromosome appear to be recurrent, and these remain to be studied for prognostic significance. Ph-negative CML comprises (1) cases of submicroscopic (hidden) insertion of 9q34-ABL within 22q11-BCR, and (2) cases without BCR-ABL rearrangement. We propose this last category to be called CML-like disease, not to be confused anymore with true CML, and consequently to be studied as a separate entity.     

Aberrant translocations in chronic myelogenous leukaemia with hidden chromosome 9 or 22 involvement

Possible mechanisms are proposed to explain how chromosome 9 or 22 involvement can be hidden in aberrant translocations in chronic myelogenous leukaemia. These mechanisms need to be confirmed or rejected using in situ hybridization.     

Lymphatic manifestation forms in the terminal phase of chronic myelocytic leukemia

A blastic transformation in chronic myeloic leukaemia (CML) is reported, which, on the one hand, is characterized by the "lymphoid" feature of blasts and, on the other hand, by the appearance of great lymph node swellings. The clear distinction from (secondary) malignant lymphomas may be difficult. The inclusion of such forms of blastic transformation in CML is based on cytogenetic findings. Their non-granulocytic or "lymphoid" nature emerges from their cytological behavior. The fact that these lymphoid transformations respond to vincristin and prednison emphasize that their recognition as special entities is justified. They also demonstrate that the neoplastic process in CML may not only involve myelopoietic but pluripotent stem cells as well.     

Antitumor activity in vitro in chronic myelogenous leukaemia revealed after treating peripheral cells with cytosine arabinoside

Summary Cytosine arabinoside (Ara-C) treatment of peripheral blood mononuclear cells from 12/12 chronicphase chronic myelogenous leukaemia (CML) patients revealed a proliferative response stimulated by their untreated leukaemic cells. Specific recognition of tumour cells by patients' normal lymphocytes was suggested by the finding that cells of siblings genotypically identical for human leukocyte antigen caused no stimulation. Lymphocytes thus stimulated by tumour cells from one of these patients were cloned by limiting dilution and tested for antileukaemic effects in cytotoxicity and proliferation assays. Cytotoxic lines were isolated that killed autologous CML targets but only a limited number of allogeneic fresh leukaemias or cell lines. These results show that anti-leukaemia effectors can be isolated from chronic-phase CML patients and suggest their potential application in adoptive immunotherapy.This work was supported by the Deutsche Forschungsgemeinschaft (SFB 120) Abbreviations used: ANLL, acute non-lymphocytic leukaemia; Ara-C, cytosine arabinoside; CML, chronic myelogenous leukaemia; IL, interleukin; LAK, lymphokine-activated killer; NK, natural killer; PBMC, peripheral blood mononuclear cells; HLA, human leukocyte antigen     

Interferon alfa-2c in chronic myelogenous leukemia (CML): hematologic, cytogenetic and molecular-genetic response of patients with chronic phase CML previously resistant to therapy with interferon gamma

Alpha- and gamma-interferons have been shown to actively suppress hematopoiesis in patients in the chronic phase of chronic myelogenous leukemia in vitro and in vivo. Since both interferons act through different receptors on their hematopoietic target cells, they are expected to be capable of independently inhibiting abnormal blood cell development in patients with chronic myelogenous leukemia. We have utilized recombinant human interferon alfa-2c to treat 11 patients with Philadelphia chromosome positive chronic myelogenous leukemia in chronic phase, who were resistant to previous interferon gamma therapy. Ten of the patients were evaluable for hematologic, cytogenetic and molecular-genetic response following interferon alfa-2c therapy for 6 to 30 months. In 5 patients, IFN alfa-2c treatment failed due to lack of hematologic response. A complete hematologic or partial hematologic response was achieved in the remaining 5 patients. Three of these experienced cytogenetic improvement with reappearence of 100% diploid hematopoietic cells and disappearence of c-abl/bcr rearrangement in one patient. In two patients interferon alfa-2c did not prevent transformation of the disease into an accelerated state or blast crisis, respectively. We conclude that recombinant human interferon alfa-2c may also control hematopoiesis in interferon-gamma resistant chronic myelogenous leukemia patients, although the long-term response will need to be elucidated in further studies.     

Cell surface marker analysis in diagnosis of the early phase of chronic lymphocytic leukaemia

Cell surface marker analysis was carried out in 50 CLL patients; 15 were preclinical or low count, that is with a total peripheral lymphocyte count well below 15,000/cmm and little or no infiltrative syndrome. Data of the cell surface marker in these 15 patients were compared with those of 15 patients with non-neoplastic benign lymphocytosis. Monoclonal B-cell compartment proliferation was found in low count cases, with analogous immnofunctional characteristics to typical CLL. On the other hand, there was a symmetrical increase in both T and B cell compartments in non-neoplastic lymphocytosis. This suggests that cell marker analysis is a very useful diagnostic tool during the preclinical phase of CLL, as it permits it to be readily differentiated from non-neoplastic lymphocytosis.     

Response to the combined administration of interferons alpha and gamma after failure of single interferon therapy in chronic myelogenous leukaemia

A previously untreated patient with benign phase chronic myelogenous leukaemia (CML) was treated with recombinant Interferon alpha-2 b. Haematological remission was induced for a total of twelve months. Thereafter, the patient developed resistance to Interferon alpha manifested by an increase in leucocyte counts despite dose escalation (up to 7 x 10(6) IU/day s.c.). Subsequent treatment with recombinant Interferon gamma failed to control myeloid proliferation. However, combined administration of both Interferon alpha and Interferon gamma resulted in a renewed haematological remission which lasted six months.     

Diagnostic and prognostic value of the terminal deoxynucleotidyl transferase (TdT) activity in treating the blastic phase (bp) of chronic granulocytic leukaemia (CGL)

The blastic cell phenotypes of 26 cases of CGL in blastic phase were estimated and the patients were treated with different schemes. The following methods of typisation of the blast cells were used: cytochemical stainings (POX, Sudan B, PAS, nonspecific esterase), estimation of TdT activity, and in 11 patients the testing with monoclonal antibodies of VI series. Using these methods 10 patients (38%) with lymphoid form of the blastic phase, 11 (43%) with the myeloid type and 5 patients (19%) with undifferentiated type were diagnosed. In the group of lymphoblastic type a longer survival time and complete remissions were observed. High TdT activity in blastic cells did correspond with favourable response to Vincristin and Prednison. The introduction of TdT assessment into the diagnosis of CGL allows the cells to be classified more precisely, thus helping in defining the prognosis and in the choice of treatment programme.