Restoration of nonclonal hematopoiesis in chronic myelogenous leukemia
(CML) following a chemotherapy-induced loss of the Ph1 chromosome
JW Singer, ZA Arlin, V Najfeld, JW Adamson, SJ Kempin, BD Clarkson and PJ Fialkow
After intensive chemotherapy, marrow cells of some patients with
Philadelphia chromosome (Ph1) positive chronic myelogenous leukemia (CML)
become partially or completely Ph1-negative. However, without a second
marker for the neoplastic clone, it could not be determined if these
Ph1-negative cells arose from normal progenitors or were still members of
an abnormal clone. In the present study, a patient with Ph1- positive CML,
also heterozygous for glucose-6-phosphate dehydrogenase (G6PD), was studied
before and after intensive chemotherapy. Prior to treatment only G6PD type
B was detected in the patient's red cells, platelets, and granulocytes, and
all unstimulated marrow metaphases had Ph1. After four cycles of
chemotherapy, 76% of marrow cells were Ph1- negative, and approximately 80%
of the granulocytes were nonclonal by G6PD analysis. Thus, the frequency of
nonclonal cells by G6PD analysis correlated closely with that of the
Ph1-negative cells. The data indicate that intensive chemotherapy can
restore nonclonal and presumably non-neoplastic hematopoiesis in CML.
Volume 56,
Issue 3,
pp. 356-360,
09/01/1980
Copyright © 1980 by The American Society of Hematology
