Preleukemia and leukemia in polycythemia vera
D Meytes, D Katz and B Ramot
A group of 76 polycythemia vera patients was followed prospectively with
bone marrow examinations at regular intervals. Six terminated in acute
leukemia, preceded by an indolent preleukemic phase succeeded by a very
fulminant leukemia. At autopsy, all patients had extramedullary
hematopoiesis. In one of them, only the bone marrow was leukemic,
suggesting that it was the primary site of this transformation. In three
with leukemic involvement of nonhematopoietic organs, the infiltrate
consisted of myelo- or myelomonoblasts and normoblasts. The preleukemic
phase was characterized by a rapidly evolving spontaneous pancytopenia,
with a drop from polycythemic blood counts within 2 mo. In the bone marrow,
megaloblastoid erythropoiesis with ring sideroblasts was prominent. A
similar preleukemic phase evolving in other potentially leukemic
conditions, has been described. Therefore, in patients at risk, the
appearance of ring sideroblasts may be regarded as an early indicator of
imminent acute leukemic transformation.
Volume 47,
Issue 2,
pp. 237-241,
02/01/1976
Copyright © 1976 by The American Society of Hematology
