Blood, 1967, Vol. 29, No. 4, pp. 652-666.
© 1967 American Society of Hematology, Inc.
Chronic Myelocytic Leukemia with Two Philadelphia
Chromosomes and Prominent Peripheral
Lymphadenopathy
CHARLES P. DUVALL 1,
PAUL P. CARBONE 1,
WILLIAM R. BELL 1,
JACQUELINE WHANG 1,
J. H. TJIO 1, and
SEYMOUR PERRY 1
1 Medicine Branch, National Cancer Institute, and the National Institute
of Arthritis and Metabolic Diseases, National Institutes of Health, Bethesda, Maryland.
1. Three adults with CML, 2 Ph1 chromosomes, and marked peripheral
lymphadenopathy are described.
2. In each instance node enlargement was thought to be due to leukemic
infiltration rather than a supervenient lymphomatous process.
3. Marked adenopathy is an unfavorable prognostic sign in CML, particularly if caused by myeloblastic infiltration. Such infiltration can precede myeloblastic involvement of the peripheral blood and bone marrow.
4. Karyotype analysis and touch preparations of extramedullary tumor tissue
in CML will aid in accurate diagnosis and may help to answer more basic
questions regarding the pathogenesis of this malignancy.
Submitted on July 5, 1966
Accepted on October 13, 1966