Korean J Lab Med.  2002 Jun;22(3):159-162.

Report of 3 Cases of Chronic Myelogenous Leukemia with Thrombocythemic Onset

• Moon HW
• Park JH
• Yoon JS
• Ahn JY
• Huh JW
• Hong KS
• Chung WS

Abstract

BACKGROUND: Differential diagnosis may be difficult between essential thrombocythemia (ET) and chronic myelogenous leukemia (CML) with marked thrombocytosis, mild leukocytosis, and a few immature myeloid cells in peripheral blood at onset. The aim of the present study was to analyze clinical, hematologic, and molecular features of patients with CML, mimicking ET.
METHODS
Among patients from Ewha and Gachon Gil Medical Center between January 1990 and June 2001, our study group included 3 patients with Ph-positive CML with marked thrombocy-tosis (>600 X 10(9)/L) and mild leukocytosis (<20 X 10(9)/L) and 12 patients of the typical ET as a con-trol group.
RESULTS
Peripheral blood basophilia (4 - 12%) and a few immature granulocytes (1 - 9%) were the characteristic features of CML with thrombocythemic onset, compared with the typical ET. There was no evidence of bone marrow eosinophilia, basophilia, or fibrosis in CML with thrombocythemic onset.
CONCLUSIONS
Our study suggests that peripheral basophilia as well as the positivity of Ph chromo-somes or bcr/abl gene rearrangement can be a clue to diagnosis of CML.

Keyword

Chronic myelogenous leukemia; Thrombocythemic onset; Basophilia; Essential throm-bocythemia

MeSH Terms

Bone Marrow
Diagnosis
Diagnosis, Differential
Eosinophilia
Fibrosis
Gene Rearrangement
Granulocytes
Humans
Hydrogen-Ion Concentration
Leukemia, Myelogenous, Chronic, BCR-ABL Positive*
Leukocytosis
Myeloid Cells
Thrombocythemia, Essential
Thrombocytosis