Blast crisis is the common terminal event in chronic myelogenous leukemia (CML). In the majority of cases, the predominant immature cells in the blood and bone marrow are either of myeloid or lymphoid origin. Less frequently transformations involve the erythroid or megakaryocytic cell lines.
We experienced a case of 37-year-old man with Ph´ -negative CML who developed a blastic transformation in which the predominant cell type was megakaryoblasts. He diagnosed as CML 8 months ago, thereafter he received irregular treatment only. When admission, he complained nasal bleeding and general weakness, and diagnosed under impression of blast crisis by morphologic and cytochemical study. After multiple chemotherapy, blast crisis was improved, but not resolved, and the blast crisis developed again 2 months later after admssion. At that time, seventy-nine percent megakaryoblasts were present at perpheral blood and we used immunoperoxidase stain for platelet specific antibody (Glycoprotein Ⅲa).
The stain was positive, and we could confirm acute megakaryoblastic crisis of CML.
|