The relationship of erythromonocytic leukemia to other myeloproliferative disorders

Shaw, Michael; Bottomley, Sylvia S.; Bottomley, R. H.; Hussein, Khader K.

doi:10.1016/0002-9343(73)90212-x

Cited by 16 publications

(3 citation statements)

References 32 publications

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“…54 Subacute and chronic myelomonocytic leukemia must also be distinguished from the acute form of myelomonocytic leukemia (AMMOL). The morphologic criteria for the diagnosis of AMMOL have been well defined.39 The prominent feature is the presence in bone marrow of a high proportion (>50%) of early precursors ofgranulocytes and monocytes.…”

Section: Cancer August 15 1984mentioning

confidence: 99%

Subacute and chronic myelomonocytic leukemia in children (juvenile CML). Clinical and hematologic observations, and identification of prognostic factors

Castro‐Malaspina

Schaison

Passe³

et al. 1984

Cancer

157

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The clinical and hematologic characteristics of 38 children with subacute and chronic myelomonocytic leukemia (S & CMMOL) are described, and the prognostic significance of these characteristics as recorded at diagnosis is reported. The common and distinctive feature of these children was the excessive proliferation of cells of neutrophilic and monocytic series. The disease predominated in younger children, 95% were younger than 4 years, and boys were more affected than girls (22/16). The onset of the disease was heralded most often by acute or subacute symptoms. Splenomegaly was the most common physical finding at diagnosis. Leukocytosis was usually under 100 × 109/I. Monocytosis and granulocytosis were often associated with normoblastosis, and, in some cases, with moderate blastosis (≦30%). Severe anemia and marked thrombocytopenia were found in about one third of patients, increased fetal hemoglobin levels in 53%, and increased γ‐globulin levels in 50% of cases. The Philadelphia chromosome was absent in all blood and marrow cell karyotypes. Thirty‐three of 38 patients were treated with moderate or intensive chemotherapy, and in all cases treatment never resulted in a complete remission. Terminal acute leukemia occurred in 11 cases. Of the 38 patients, 29 have died (median survival time, 16 months). Initial characteristics predicting a short survival (log‐rank test) included: older age (≦2 years) (P < 0.001), hepatomegaly (P < 0.05), bleeding (P < 0.001), thrombocytopenia (P < 0.01), high counts of blasts and normoblasts in peripheral blood (P < 0.01, P < 0.01). Sex, infections, cutaneous manifestations, lymphadenopathy, degree of splenomegaly, hemoglobin levels, fetal hemoglobin, leukocyte counts, percent of blasts in bone marrow, and serum γ‐globulin levels were of no prognostic value. When survival was plotted on a semilogarithmic scale, a change in death rate was evident at the second year of survival suggesting that there may be two subgroups of patients with myelomonocytic picture, one with very rapid, and another with a much slower rate of mortality. A stepwise discriminant‐function analysis was performed in an attempt to distinguish between those children who lived ≦2 years and those who lived longer. A linear combination of variables which best discriminated between these two subgroups was found. Nearly all patients could be classified as a short‐survivor or long‐survivor on the basis of age and platelet, blast, and normoblast counts in peripheral blood. This discriminant function may be used for the estimation of prognosis and, accordingly, for the selection of the appropriate therapy of new cases.

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Section: Cancer August 15 1984mentioning

confidence: 99%

Subacute and chronic myelomonocytic leukemia in children (juvenile CML). Clinical and hematologic observations, and identification of prognostic factors

Castro‐Malaspina

Schaison

Passe³

et al. 1984

Cancer

157

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“…Marked erythroblastaemia was not seen in spite of initial marrow erythroblast hyperplasia, but the terminal cytological evolution resembled that described by H indmarsh and Wickham [15] in erythraemic myelosis terminating in erythroleukaemia, with myelomonocytic cells suggestive of Naegeli paramyeloblastic leukaemia. Myelomonocytic morphology of leukaemic leu cocytes is well recognized in erythroleukaemia, as well as interconverti bility with various myeloproliferative syndromes which may all be essen tially neoplastic [26,28].…”

Section: Discussionmentioning

confidence: 99%

Occurrence of Haemoglobin H in Leukaemia: a Further Case of Erythroleukaemia

Beaven¹,

Coleman²,

White³

1978

Acta Haematol

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Erythroleukaemia in an elderly Caucasian male was associated with the presence of 15% of haemoglobin H (Hb-H; Hb-β₄) in the haemolysate, identified by electrophoretic analysis, isolation and ‘finger-printing’. The peripheral blood picture was dimorphic, with 40% of hypochromic and morphologically abnormal red cells. Inclusion bodies indicative of the presence of Hb-H occurred in 30% of the red cells after supravital staining. The rare occurrence of Hb-H in leukaemic conditions and its distribution in the red cells is discussed in relation to the possible clonal origin of leukaemia and the involvement of red cell precursors.

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“…names of subacute myelomonocytic leuke mia [38,50,51] or chronic erythromonocytic leukemia [12,39]. Besides splenomegaly and monocytosis the most striking features of CMML are a significant increase in both plasmatic and urinary muramidase [13,29,49,53] and the results of bone marrow cul ture [19,31,42,50].…”

Section: Introductionmentioning

confidence: 99%

Chronic Myelomonocytic Leukemia Associated with Hereditary Pyruvate Kinase Deficiency and Multiple Acquired Erythrocyte Abnormalities

Vives‐Corrons¹,

Florensa²,

Muncunill³

et al. 1979

Acta Haematol

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A congenital erythrocyte pyruvate kinase (PK) deficiency was found in a 72-year-old female patient with chronic myelomonocytic leukemia (CMML). Erythrocyte PK deficiency was associated with an increase in the activity of hexokinase, 6-phospho-gluconate dehydrogenase and glutathione peroxidase in erythrocytes as well as a decrease in acetylcholinesterase, glutathione reductase and glucosephosphate isomerase activities. The enzymatic abnormalities were accompanied by alterations in hemoglobin and in i antigen content of erythrocyte membrane. In addition, bone marrow ultrastructural studies showed dyshemopoietic changes in all blood cell lines and especially in erythroblasts. The present findings confirm the close relationship between CMML and acquired dyserythropoietic syndromes and constitute a new observation of the infrequent association of hereditary erythrocyte enzymopathies and leukemia. A survey of the literature is presented.

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The relationship of erythromonocytic leukemia to other myeloproliferative disorders

Cited by 16 publications

References 32 publications

Subacute and chronic myelomonocytic leukemia in children (juvenile CML). Clinical and hematologic observations, and identification of prognostic factors

Subacute and chronic myelomonocytic leukemia in children (juvenile CML). Clinical and hematologic observations, and identification of prognostic factors

Occurrence of Haemoglobin H in Leukaemia: a Further Case of Erythroleukaemia

Chronic Myelomonocytic Leukemia Associated with Hereditary Pyruvate Kinase Deficiency and Multiple Acquired Erythrocyte Abnormalities

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