Extramedullary blast crisis in chronic myeloid leukemia

Leuk Res. 1996 Nov-Dec;20(11-12):905-8. doi: 10.1016/s0145-2126(96)00054-9.

Abstract

Among 235 patients with CML we reviewed 91 patients with BC diagnosed between 1980 and 1995; 15 of the 91 (16%) developed extramedullary disease (EMD). The sites involved were the lymph nodes (13/15), CNS (1/15) and suborbital mass (1/15). The appearance of EMD was associated with chronic phase (CP) features in the bone marrow in 3/15 cases, with accelerated phase (AP) in 3/15 and with BC in 9/15. 11/15 (73%) cases of EMD were classified as myeloid (My-EMD) and 4/15 as lymphoid-type (Ly-EMD): three B-phenotype and one T-phenotype. All Ly-EMD cases were treated with vincristine, daunorubicin and prednisone and obtained complete remission (CR). Cases of My-EMD were treated with daunorubicin and cytosine arabinoside, of which only 1/11 achieved CR. We suggest that in EMD also, the type, lymphoid or myeloid, of BC has a bearing on treatment response and prognosis: Ly-EMD is more responsive to treatment and has longer survival than My-EMD.

Publication types

  • Review

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Agents, Alkylating / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Blast Crisis / drug therapy
  • Blast Crisis / epidemiology
  • Blast Crisis / pathology*
  • Blast Crisis / radiotherapy
  • Bone Marrow Transplantation
  • Busulfan / therapeutic use
  • Central Nervous System / pathology*
  • Combined Modality Therapy
  • Cytarabine / administration & dosage
  • Daunorubicin / administration & dosage
  • Female
  • Humans
  • Hydroxyurea / therapeutic use
  • Interferon alpha-2
  • Interferon-alpha / therapeutic use
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / epidemiology
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / pathology*
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / therapy
  • Leukemia, Myeloid, Accelerated Phase / drug therapy
  • Leukemia, Myeloid, Accelerated Phase / pathology
  • Leukemia, Myeloid, Chronic-Phase / drug therapy
  • Leukemia, Myeloid, Chronic-Phase / pathology
  • Lymph Nodes / pathology*
  • Male
  • Middle Aged
  • Orbit / pathology*
  • Prednisone / administration & dosage
  • Recombinant Proteins
  • Remission Induction
  • Retrospective Studies
  • Survival Rate
  • Vincristine / administration & dosage

Substances

  • Antineoplastic Agents, Alkylating
  • Interferon alpha-2
  • Interferon-alpha
  • Recombinant Proteins
  • Cytarabine
  • Vincristine
  • Busulfan
  • Prednisone
  • Hydroxyurea
  • Daunorubicin