RAZELLE KURZROCK, M.D.; MARK B. BLICK, D.O.; MOSHE TALPAZ, M.D.; WILLIAM S. VELASQUEZ, M.D.; JOSE M. TRUJILLO, M.D.; NICOLA M. KOUTTAB, Ph.D.; WILLIAM S. KLOETZER, Ph.D.; RALPH B. ARLINGHAUS, Ph.D.; JORDAN U. GUTTERMAN, M.D.
We have followed one patient with Philadelphia (Ph)-negative chronic myelogenous leukemia and identified an additional four patients from the literature who showed the rearrangement in the breakpoint cluster region (bcr) on chromosome 22 characteristic of Ph-positive chronic myelogenous leukemia. The clinical course of these five patients was similar to that of Ph-positive patients, with easily controlled leukocyte counts, a prolonged benign phase, and prolonged survival. Furthermore, we have shown, for the first time, that bcr rearrangement in Ph-negative chronic myelogenous leukemia can result in expression of the aberrant 210-kilodalton bcr-abl fusion protein, which has been strongly implicated in Ph-positive leukemogenesis. Research data pertaining to possible cytogenetic mechanisms leading to production of p210bcr-abl in the absence of the Ph chromosome are reviewed. Molecular analysis provides an important tool for classifying and predicting prognosis of some patients with Ph-negative chronic myelogenous leukemia.
RAZELLE KURZROCK, MARK B. BLICK, MOSHE TALPAZ, WILLIAM S. VELASQUEZ, JOSE M. TRUJILLO, NICOLA M. KOUTTAB, et al. Rearrangement in the Breakpoint Cluster Region and the Clinical Course in Philadelphia-Negative Chronic Myelogenous Leukemia. Ann Intern Med. 1986;105:673–679. doi: 10.7326/0003-4819-105-5-673
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Published: Ann Intern Med. 1986;105(5):673-679.
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