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A prospective long-term cytogenetic study in polycythemia vera in relation
to treatment and clinical course
B Swolin, A Weinfeld and J Westin
Department of Clinical Chemistry, Sahlgren's Hospital, Gothenburg
University, Sweden.
This paper reports the results of cytogenetic studies in a consecutive
series of 64 patients with polycythemia vera, 57 of whom could be followed
prospectively. The median length of the cytogenetic observation time was 93
months (range, 24 to 224 months) after diagnosis. Clonal chromosome
abnormalities were observed initially in 11 patients (17%) and later during
the course of the disease in another 20 patients. An abnormal karyotype was
found in 71% to 80% of the patients who were examined after the development
of myeloid metaplasia, myelofibrosis, or leukemia. Patients treated with
myelosuppressive agents showed a significantly greater risk of chromosome
abnormalities developing than did patients who had been phlebotomized.
Acute leukemia developed in eight patients, all of whom had been treated
with myelosuppressive agents. A chromosome abnormality preceded the
leukemia in only two of the patients. The initial presence of an abnormal
karyotype did not predict a greater risk of development of leukemia. No
consistent relationship was demonstrated between the occurrence of
chromosome abnormalities and the development of myeloid metaplasia and/or
myelofibrosis, which was observed in 42% of the patients. The chromosome
abnormalities followed a nonrandom pattern, and those most frequently
observed were trisomies for 1 q, 8, 9, or 9p and deletion of 20q. Deletions
seem to be common and were found in 14 patients.
Volume 72,
Issue 2,
pp. 386-395,
08/01/1988
Copyright © 1988 by The American Society of Hematology
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