Chronic myelogenous leukemia(CML) is one of a group of hematologic disorders characteriz-d by a proliferative abnormality in the stem cell, associated
with specific cytogenetic abnormality the Phi adelphia (Ph1) chromnosome, marked increasing leuko yte and huge enlarged spleen.
It is classified as one of the myeloproliferat ve syndromes, and its course is typically characteriz.d by an insidious onset, a prolonged "benign period; and a terminal phase the so called blastic crisis.
This is to report a clinical study of 21 ca-es with CML who had. been admitted to the depart of Int. Med., National Medical Center during th- period from June 1966 to September 1977.
The results obtained are as follows;
1. The male to female ratio was 1 : 1. C. The patient´s age at the time of the first evidence of disease ranged from 18 to 54 years with mean age of 34.9 years.
2. The mean duration from the onset of symptoms
to diagnosis was about 7.8 months with range of 1 month to 16 months
3, The clinical symptoms were as followings in frequency; weakness and fatigue(85.7%). abdominal discomfort & pain(76.1%), palpable abdominal mass (71.4%), febrile sensation(42.8%), bleeding & bruising(42.8% ).
4. The spleen is palpable in 20 cases(95.2%)except one patient in remission state. Hepatomegaly was present in 12(57.1%), sternal tenderness in 3(14.3 %), purpura in 2(9.5%) and lymphadenopathy in 1 case out of l0.
5. Hematologic findings in 19 cases except 2 cases with blastic crisis on admission are as follows; (1) The mean Hgb value is 9.0g%, mean WBC count, 220,000/mm3 and mean platelet count, 250,000/mm3 ThrombocytosisCover 450, 000/mm3) was observed in 4 cases. The mean value of myeloblast and promyelocyte on differential count were 3.5% and 6. 0% respectively.
6. The average uric acid concentration level was 5. 5mg% with the range of 2. 8mg% to 8.0mg%.
7. In 8 of 21 cases were perfomed cytogenetic study, which ´revealed Philadelphia chromsome. in all cases. Also we studied neutrophil leukocyte alkaline phosphatase in same cases. The LAP score is zero or low in 7 cases, one case showed high score(225), which case was checked during blastic crisis.
8. Busulfan therapy was available in 14 of 21 cases from 6 months to 7 years (median 1 year), of them 5 were alive, 5 were lost to follow up and 4 were dead.
9. Remission was achieved in 13 cases. The median -duration to remission -in 7 patients who were well followed up was 85 daysCrange, 28-159 days).
10. Blastic crisis was occured in 6 cases among 21. The cause of death in patients with blastic crisis are G-I bleeding(3 cases), sepsis(2 cases) and C.V.A. (1case).
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