Summary
Acute lymphoblastic transformation of chronic myeloid leukaemia (LT-CML) of 7 consecutive patients was treated according to a remission-induction and maintenance therapy used for de novo acute lymphoblastic leukaemia (ALL). All 7 patients achieved a second chronic phase with a median remission duration of 15 months. Two patients showed an isolated central nervous system (CNS) relapse. This did not occur in the 4 patients, who received prophylactic therapy with intrathecal methotrexate. The second transformation was nonlymphoblastic in nature in 4 out of the 5 patients. A treatment protocol similar to that of a bad risk ALL, including long-term maintenance therapy and CNS-prophylaxis is indicated in lymphoblastic transformation of CML.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Boggs DR (1974) Hematopoietic stem cell theory in relation to possible lymphoblastic conversion of chronic myeloid leukemia. Blood 44: 449–453
Canellos GP, DeVita VT, Whang-Peng J, Chabner BA, Schein PS, Young RC (1976) Chemotherapy of the blastic phase of chronic granulocytic leukemia: hypodiploidy and response to therapy. Blood 47: 1003–1009
Fialkow PJ, Jacobsen RJ, Papayannopoulou T (1977) Chronic myelocytic leukemia: clonal origin in a stem cell common to the granulocyte, erythrocyte, platelet and monocyte/macrophage. Am J Med 63: 125–130
Griffin JD, Todd III RF, Nadler LM, Canellos GP, Rosenthal D, Gallivan M, Beveridge RP, Weinstein H, Karp D, Schlossman SF (1983) Differentiation patterns in the blastic phase of chronic myeloid leukemia. Blood 61: 85–91
Jacobs AD, Gale RP (1984) Recent advances in the biology and treatment of acute lymphoblastic leukemia in adults. N Engl J Med 311: 1219–1231
Janossy G, Woodruff RK, Pippard MJ (1979) Relation of lymphoid phenotype and response to chemotherapy incorporating vincristine-prednisone in the acute phase of Ph' positive leukemia. Cancer 43: 426–434
Koeffler HP, Golde DW (1981) Chronic myelogenous leukemia — New concepts. N Engl J Med 304: 1201–1209, and 1269–1274
Marks SM, Baltimore D, Mc Caffrey R (1978) Terminal transferase as a predictor of initial responsiveness to vincristine and prednisone in blastic crisis of chronic myelogenous leukemia. N Engl J Med 298: 812–814
Rowley JD (1975) Nonrandom chromosomal abnormalities in hematological disorders of man. Proc Natl Acad Sci USA 72: 152–156
Tax W, Tidman N, Janossy G, Trejdosiewicz L, Willems R, Leeuwenberg J, De Witte T, Capel P, Koene R (1984) Monoclonal antibody (WT 1) directed against a T cell surface glycoprotein: characteristics and immunosuppressive activity. Clin Exp Immunol 55: 427–436
Willemze R, Hillen H, Hartgrink-Groeneveld CA, Haanen C (1975) Treatment of acute lymphoblastic leukaemia in adolescents and adults: a retrospective study of 41 patients (1970–1973). Blood 46: 823–834
De Witte T, Raymakers R, De Pauw B, Haanen C (1985) Repetitive cycles of cytoreductive therapy followed by stem cell autografting for nonlymphoblastic transformation of chronic granulocytic leukaemia. Scand J Haemat 35: 421–426
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
de Witte, T., de Pauw, B. & Haanen, C. Remission-induction of acute lymphoblastic transformation of chronic myeloid leukaemia, followed by long-term maintenance therapy. Blut 52, 231–235 (1986). https://doi.org/10.1007/BF00321082
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00321082