Ns. Rosenthal et al., PROMYELOCYTIC BLAST CRISIS OF CHRONIC MYELOGENOUS LEUKEMIA - A RARE SUBTYPE ASSOCIATED WITH DISSEMINATED INTRAVASCULAR COAGULATION, American journal of clinical pathology, 103(2), 1995, pp. 185-188
Two patients with chronic myelogenous leukemia (CML) developed blast c
risis that morphologically appeared to be the microgranular variant of
acute promyelocytic leukemia. This represented 8% of CML patients dev
eloping blast crisis from 1984 to 1993. Cytogenetic studies revealed t
ranslocation 15;17 in addition to translocation 9;22 that had been doc
umented at initial diagnosis. Both patients had evidence of disseminat
ed intravascular coagulation at the onset or during treatment of blast
crisis, which was not documented in any other patients with CML blast
crisis. One patient died of sepsis during intensive chemotherapy. The
second returned to a chronic phase of the disease after therapy. Alth
ough rare, a promyelocytic blast crisis of CML can occur which, as in
de novo acute promyelocytic leukemia, has a propensity to produce diss
eminated intravascular coagulation.