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Clinical presentation and natural history of patients with essential thrombocythemia and the Philadelphia chromosome
Author(s) -
Stoll D. B.,
Peterson P.,
Exten R.,
Laszlo J.,
Pisciotta A. V.,
Ellis J. T.,
White P.,
Vaidya K.,
Bozdech M.,
Murphy S.
Publication year - 1988
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.2830270202
Subject(s) - essential thrombocythemia , basophilia , leukocytosis , philadelphia chromosome , chronic myelogenous leukemia , medicine , bone marrow , atypia , pathology , myelofibrosis , leukemia , polycythemia vera , chromosomal translocation , biology , genetics , gene
Six women presented with the clinical picture of essential thrombocythemia (ET) without the anemia, marked splenomegaly, and extreme leukocytosis characteristic of chronic myelogenous leukemia (CML). All had the Philadelphia chromosome on karyotype analysis of the bone marrow. Peripheral basophilia was present in four cases, providing a clinical clue that the Philadelphia chromosome might be present. Marrow biopsy showed granulocytic hyperplasia and either small megakaryocytes or sheets of megakaryocytes with marked atypia, findings that are more typical of CML than ET. The clinical importance of finding the Philadelphia chromosome in patients who seem to have ET is in assessing prognosis. ET generally follows a chronic, indolent course. However, five of these six patients who had the Philadelphia chromosome underwent clinical transition to the accelerated phase of CML or blastic leukemia in 4–7 years.