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Philadelphia chromosome‐negative chronic myelogenous leukaemia: a morphological reassessment
Author(s) -
Pugh William C.,
Pearson Marilyn,
Vardiman James W.,
Rowley Janet D.
Publication year - 1985
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/j.1365-2141.1985.tb07443.x
Subject(s) - basophilia , myelodysplastic syndromes , medicine , chronic myelomonocytic leukemia , dysplasia , chronic myelogenous leukemia , philadelphia chromosome , international prognostic scoring system , pathology , bone marrow , gastroenterology , leukemia , chromosomal translocation , biology , genetics , gene
S ummary Morphological re‐examination of 25 cases classified as Ph 1 ‐negative chronic myelogenous leukaemia (CML), with particular attention to the recent French‐American‐British (FAB) group proposals for the diagnosis of the myelodysplastic syndromes, led to reclassification of all but one of these cases. Upon review of pretreatment material, seven of the 25 cases (28%) were considered to represent myeloproliferative and reactive conditions other than CML. Of the remaining 18 cases, 17 (94%) were reclassified as myelodysplastic syndromes (MDS). These included one case of refractory anaemia (RA), three of refractory anaemia with excess of blasts (RAEB), four of RAEB in transformation (RAEBT), and nine of chronic myelomonocytic leukaemia (CMMoL). Haematological findings in these 17 patients were compared to those in 50 randomly selected patients with Ph 1 ‐positive CML. Whereas an absolute basophilia in the peripheral blood was a nearly constant feature in the Ph 1 ‐positive group, it was lacking in all but one of the patients with myelodysplastic syndromes. Differences in the pattern and degree of dysplasia were also noted. Only one of the 25 cases studied was considered morphologically and clinically indistinguishable from Ph 1 ‐positive CML. It appears that Ph 1 ‐negative CML constitutes a heterogeneous group of prognostically distinct disorders and the, in most instances, careful morphologic examination will permit precise classification.