This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

Development of Blast Crisis With Both Lymphoid and Myeloid Features

Keith M. Skubitz, MD; Philip R. Craddock, MB, BS, FRACP; Daniel J. Weisdorf, MD; James E. Niedel, MD, PhD; Tucker W. LeBien, PhD; John H. Kersey, MD; Richard D. Brunning, MD; Janet L. Parkin; Patrick J. Flynn, MD; Dale E. Hammerschmidt, MD

JAMA. 1983;250(21):2957-2960.

Abstract
A 50-year-old man had chronic myelogenous leukemia and entered a blast crisis that was both morphologically and histochemically lymphoid. The blasts contained terminal deoxyribonucleotidyl transferase and expressed lymphoblastic leukemia-associated antigen. He rapidly entered remission with vincristine sulfate and prednisone therapy. Nevertheless, his blasts displayed a marker generally considered unique to myeloid cells: they selectively bound the granulocyte chemotaxin N-formyl-Met-Leu-Phe. In addition, some cells contained granules resembling those of basophils or mast cells. Such mixed myeloid-lymphoid features in chronic myelogenous leukemia blast cells may reflect malignant transformation of a stem cell capable of both myeloid and lymphoid differentiation, or they may reflect the dedifferentiation as a feature of malignant change.

(JAMA 1983;250:2957-2960)

Author Affiliations
From the Departments of Medicine (Drs Skubitz, Craddock, Weisdorf, Flynn, and Hammerschmidt) and Laboratory Medicine and Pathology (Drs LeBien, Kersey, and Brunning and Ms Parkin), University of Minnesota Medical School, Minneapolis; and the Department of Medicine, Duke University Medical School, Durham, NC (Dr Niedel). Dr Craddock is now with the Department of Medicine, University of Kentucky, Lexington.

Footnotes
Reprint requests to Section of Medical Oncology, University of Minnesota School of Medicine, Box 286, Mayo Memorial Building, 420 Delaware St SE, Minneapolis, MN 55455 (Dr Skubitz).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?