Abstract
Fourteen cases of Philadelphia (Ph′) chromosome positive CML blast crisis, originally described by Janossy et al. (1976) were followed to determine the incidence of CNS leukaemia. The incidence was higher in those with lymphoid (L-type) blast crisis (three out of eight cases). The study was then extended to a random selection of cases, all of whom had had cell marker analyses carried out. Six out of 34 cases (approximately 18 per cent) of Ph′ positive acute lymphoid leukaemia (ALL) or L-type blast crisis who had cells expressing the ALL antigen (ALL+ cells) present during the course of their illness developed CNS leukaemia. Thirty-eight patients with myeloid (M-type) transformation did not develop CNS disease. The blast cell characteristics, clinical course and haematological findings are described in these patients. CNS leukaemia occurred between 5 and 11 months after diagnosis. Five out of the six cases had obtained remission with vincristine and prednisolone (V and P). Such patients should be treated as adult ALL and CNS prophylaxis should be given as soon as remission is achieved.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Beard, M. E. J., Durrant, J., Catovsky, D., Wiltshaw, E., Amess, J. L., Brearley, R. L., Kirk, B., Wrigley, P. F. M., Janossy, G., Greaves, M. F. and Galton, D. A. G. (1976). Blast crisis of chronic myeloid leukaemia (CML). I. Presentation simulating acute lymphoid leukaemia. Br. J. Haemat., 34, 169.
Bennett, J. M., Catovsky, D., Daniel, M-T., Flandrin, G., Galton, D. A. G., Gralnick, H. R. and Sultan, C. (1976). Proposals for the classification of the acute leukaemias. Br. J. Haemat., 33, 451.
Boggs, D. R. (1974). Haematopoietic stem cell theory in relation to possible lymphoblastic conversion of chronic myeloid leukaemia. Blood, 44, 449.
Evans, A. E., Gilbert, E. S. and Zandstra, R. (1970). The increasing incidence of central nervous system leukaemia in children. Cancer, 26, 404.
Greaves, M. F., Brown, G., Rapson, N. T. and Lister, T. A. (1975). Antiserum to acute lymphoblastic leukaemia cells. Clin. Immunol. Immunopath., 4, 67.
Janossy, G., Greaves, M. F., Revesz, T., Lister, T. A.., Roberts, M., Durrant, J., Kirk, B., Catovsky, D. and Beard, M. E. J. (1976). Blast crisis of chronic myeloid leukaemia (CIA). II. Cell surface marker analysis of ‘lymphoid’ and myeloid cases. Br. J. Haemat., 34, 179.
Janossy, G., Greaves, M. F., Sutherland, R., Durrant, J. and Lewis, C. (1977). Comparative analysis of membrane phenotypes in acute lymphoid leukaemia and in lymphoid blast crisis of chronic myeloid leukaemia. Leukaemia Res., 1, 289.
Janossy, G., Roberts, M., Greaves, M. F., Woodruff, R. K., Pippard, M., Prentice, G. and Hoffbrand, A. V. (1977). Lymphoid blast crisis in chronic myeloid leukaemia and Philadelphia positive acute lymphoid leukaemia. 2nd Int. Symp. Ther. Acute Leukaemias, Rome.
Janossy, G., Woodruff, R. K., Paxton, A., Greaves, M. F. Capellaro, D., Kirk, B., Innes, E. M., Eden, O. B., Lewis, C., Catovsky, D. and Hoffbrand, A. V. (1978). Membrane marker and cell separation studies in Ph’ positive leukaemia. Blood, 51, 861.
McCaffrey, R., Harrison, T. A., Parkman, R. and Baltimore, D. (1975). Terminal deoxynucleotidyl transferase activity in human leukaemic cells and in normal human thymocytes. New Engl. J. Med., 292, 775.
Marmont, A. M. and Damasio, E. E. (1973). The treatment of terminal metamorphosis of chronic granulocytic leukaemia with corticosteroids and vincristine. Acta Haemat., 51, 1.
Peterson, L. C., Bloomfield, C. D. and Brunning, R. D. (1976). Blast crisis as an initial or terminal manifestation of chronic myeloid leukaemia. Am. J. Med., 60, 209.
Pippard, M. J., Callendar, S. T. and Sheldon, P. W. E. (1979). Infiltration of central nervous system in adult acute myeloid leukaemia. Br. med. J., i, 227.
Roberts, M. and Greaves, M. F. Maturation linked expression of myeloid cell surface antigen. Br. J. Haemal. (in press).
Schwartz,J. H., Canellos, G. P., Young, R. C. and De Vita, V. T. (1975). Meningeal leukaemia in the blastic phase of chronic granulocytic leukaemia. Am. J. Med., 59, 819.
Woodruff, R. K., Malpas, J. S., Wrigley, P. F. M., Lister, T. A., Paxton, A. M. and Janossy, G. (1977). Meningeal leukaemia in lymphoid blast crisis of chronic myeloid leukaemia. Br. med. J., ii, 1325.
Editor information
Editors and Affiliations
Copyright information
© 1979 J. Durrant, G. Janossy and R. K. Woodruff
About this chapter
Cite this chapter
Durrant, J., Janossy, G., Woodruff, R.K. (1979). CNS Leukaemia in Blast Cell Crisis in CML and Philadelphia (Ph′) Positive Acute Lymphoid Leukaemia. In: Whitehouse, J.M.A., Kay, H.E.M. (eds) CNS Complications of Malignant Disease. Palgrave Macmillan, London. https://doi.org/10.1007/978-1-349-04285-2_9
Download citation
DOI: https://doi.org/10.1007/978-1-349-04285-2_9
Publisher Name: Palgrave Macmillan, London
Print ISBN: 978-1-349-04287-6
Online ISBN: 978-1-349-04285-2
eBook Packages: MedicineMedicine (R0)